1/2. waterhouse-friderichsen syndrome as a result of non-meningococcal infection.waterhouse-friderichsen syndrome--massive adrenal haemorrhage in the setting of overwhelming clinical sepsis--is usually taken at necropsy to indicate meningococcal infection, and may be the only evidence of this pathogen. This report describes three fatal cases of the syndrome in which the causative organism proved to be a streptococcus. The organisms were detected during routine coroners' autopsies with histology and microbiological investigations. In two cases, the syndrome followed streptococcus pneumoniae infection and in a third beta haemolytic streptococcus group A. Thus, adrenal haemorrhage alone cannot be taken to indicate meningococcal disease and other pathogens, particularly streptococcus, must be considered.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/2. waterhouse-friderichsen syndrome complicating primary biliary sepsis due to pasteurella multocida in a patient with cirrhosis.pasteurella multocida is an opportunistic pathogen causing bacteraemia in patients with liver dysfunction. A fulminant case of acute cholecystitis and septicaemia caused by P multocida, complicated by waterhouse-friderichsen syndrome without skin haemorrhage, is reported in a previously healthy 64 year old Chinese woman. The patient presented with a six hour history of sudden onset epigastric pain, vomiting, chills, and rigors. A presumptive diagnosis of cholangitis with septicaemic shock was made. disease progression was rapid and the patient died within eight hours of symptom onset. This case is further proof that skin and mucosal haemorrhages are not an essential feature of waterhouse-friderichsen syndrome and this condition should be suspected in all patients presenting with sudden illness and fulminant septicaemia.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |