“…The initial onset of IMD follows the clinical course of a classic bacterial infection which may pose a challenge for the attending physician. Typically, a nonspecific febrile illness with chills, muscle aches, nausea, and vomiting may precede the development of more specific features of meningococcal infection, such as classic features of meningitis (e.g., headache, neck stiffness, photophobia, and altered mental state); however, less than a third of patients will present with this traditional "typical" diagnostic combination [5,7]. In approximately 40%e70% of patients with meningococcal disease, the nonspecific features will progress to sepsis due to meningococcal septicemia, with signs of circulatory insufficiency, shock, and the pathognomonic petechial/purpuric rash [8].…”