What could cause crp to be 230, sed <97? acute illness. no sepsis, no rash. fever of 103, low bp, tachycardic. have more info and test results. ideas?

Need evaluation: This sounds like a systemic illness, or an infectious disease. Would start with infectious disease consultant and also depending on the outcome rheumatology.

Inflammatory state: You could well have a rheumatic condition also. The CRP and ESR are non-specific indicators of an inflammatory process going on in your body. You need a complete and thorough workup probably at the nearest major University Hospital. Either in the division of Rheumatology or Infectious Disease. Good luck!