<prompt> A 15-year-old boy presents to you with history of fever, altered sensorium and purpuric rash for two days. On examination, the patient is found stuporous. He has BP of 9060 mm Hg and extensive palpable purpura over the legs. Which of the following would be the most appropriate initial choice of antibiotic?VancomycinPenicillin GCiprofloxacinCeftriaxone  <response>: The clinical pointers are in our of Meningoccal sepsis. Usually asymptomatic nasopharyngeal colonization Early symptoms Fever, headache, and myalgia accompanied by vomiting and abdominal pain. Non blanching rash80, if present, may appear to be early in the course until petechiae or purpuric lesions develop. Purpura fulminans occurs in severe cases, with multiple large purpuric lesions and signs of peripheral ischemia. Late symptoms Meningitis 30 -50 Septicaemia 20 Rx- Empirical antibiotic therapy for suspected Meningococcal disease consists of a third-generation cephalosporin such as ceftriaxone or cefotaxime to cover the various other potentially penicillin-resistant bacteria that may produce an indistinguishable clinical syndrome. 