Concerning for meningitis. Yes, even with abdominal pain, which can be so severe that it can mimic appendicitis. Remember that splenectomy status predisposes to infection with encapsulated organisms such as meningococcus. This may also be purposefully vague, as in real life this could also certainly be an abdominal process like actual appendicitis, for which you might get an appendix ultrasound or CT of the abdomen/pelvis in addition to starting empiric antibiotics, but that’s not an answer choice.