JA is a 3-year-old male who regularly attends a crowded day care facility. He is typically a very active and energetic boy; however, his mother had difficulty waking him up one morning. Closer inspection revealed a petechial rash on his abdomen. She took his temperature and found that he had a fever of 104°F. He volunteered that he had a headache and felt nauseous. JA was brought to the emergency room where he was examined and a lumbar puncture was performed. Gram stain