19-year-old female was taken to the ER by her roommate. She had been feeling well until approximately 4 hours earlier when she began to vomit and experience some diarrhea. She seemed confused, and her roommate was concerned. PE revealed an acutely distressed female with a temperature of 103°F. She had bloodshot eyes. BP was 75/45 and pulse 60. CBC revealed a WBC of 9,800/uL with 68% PMNs, Hematocrit of 42% and Hemoglobin of 14 g/dL. She had been menstruating, and was using tampons. The tampon was removed, and a vaginal culture was obtained.