Exhibits Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again. 16-year-old adolescent brought to the ED for a sudden onset of fever. headache, and reports of sensitivity to light. Guardian reports adolescent refuses to eat or drink due to nausea and vomiting. Adolescent is lethargic and drowsy but arouses with verbal stimuli. Irritable when aroused. Pupils equal, round, reactive to light, accommodation (PERRLA). Hand grasps and pedal pulls and pushes are strong and equal bilaterally. Mucous membranes are dry and pink. Skin is very warm and dry to touch. Capillary refill is 2 seconds. Photophobia is present. Adolescent reports headache as a 10 on a numeric pain scale of 0 to 10. Resists flexion of the neck. Has small pinpoint purpuric rash bilaterally on lower extremities.