A 16-year-old girl presents to the ED with persistent fever and headache for 9 days. She was previously healthy except for a tooth extraction 3 weeks ago, for which she received penicillin. She denies shortness of breath, visual changes, vomiting, diarrhea, palpitations, joint pain, weight loss, cough, or urinary symptoms. She had been seen repeatedly in the ED and had normal examination findings and unremarkable CBC, CSF analysis, and urinalysis. She was given intramuscular ceftriaxone and sent home with a prescription for oral azithromycin. After returning to the ED today, she is admitted.
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