Abstract Acase of meningococcal septicemia in a male child was reported in Nov. 2014 at Government Medical College, Latur. The main features were fever with rash, respiratory distress since 4 days and altered sensorium since 2 days. The rash was purpuric and present all over the body including palms and soles. Gram stain from purpuric sites showed Gram negative diplococci suggestive of Neisseria meningitidis. In case of meningococcal disease, some patients develop acute meningococcemia whilst others develop meningitis. The mechanism is unknown, but the case fatality of acute meningococcemia is tenfold than that of meningococcal meningitis. It is possible that the delay in diagnosis of meningococcal disease with a maculo-papular rash alone might contribute to mortality as these children are thought to have viral illnesses and are not started on antibiotic treatment. Thus it is important to recognize this life-threatening condition in the initial stable phase to provide the emergency management so as to reduce mortality.