Q. A 19-year-old college student presents with rapid onset of malaise, myalgias, vomiting, photophobia, and a temperature of 103.6°F. She rapidly develops leg pains along with a rash. She states, “darkness is too bright, and silence is too loud.” She is transferred to a local hospital. She is given two (2) liters of intravenous saline and her blood pressure stabilizes at 82/49. Physical examination reveals positive Kernig and Brudzinski signs, a petechial rash on her lower extremity, and diffuse abdominal tenderness. Cerebrospinal fluid shows 1300 WBCs/mm³ and 10 RBCs/mm³. Gram stain shows multiple gram-negative diplococci. Which aspect of this disease process most likely contributes to her hypotension, vomiting, and diffuse abdominal tenderness?