USMLE step 2 Mcq 113:A 6 year old with a two day history of a severe headache develops fever and a spreading purplish rash

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Question:
A 6 year old with a two day history of a severe headache develops fever and a spreading purplish rash. On examination the child is noted to be lethargic and confused and to have nuchal rigidity. The change in mental status is likely to be secondary to

a) encephalitis
b) child abuse
c) meningitis
d) aneurysmally dilated great vein of Galen
e) disseminated gonorrhea


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