Waterhouse–Friderichsen syndrome


Waterhouse-Friderichsen syndrome (WFS) is a disease of the adrenal glands most commonly caused by the bacterium Neisseria meningitidis. The infection leads to massive hemorrhage into one or (usually) both adrenal glands.[1] It is characterized by overwhelming bacterial infection meningococcemia, low blood pressure and shock, disseminated intravascular coagulation (DIC) with widespread purpura, and rapidly developing adrenocortical insufficiency.

Symptoms - Waterhouse–Friderichsen syndrome

WFS is the most severe form of meningococcal septicemia. The onset of the illness is nonspecific with fever, rigors, vomiting, and headache. Soon a rash appears; first macular, not much different from the rose spots of typhoid, and rapidly becoming petechial and purpuric with a dusky gray color. Low blood pressure (hypotension) is the rule and rapidly leads to septic shock. The cyanosis of extremities can be impressive and the patient is very prostrated or comatose. In this form of meningococcal disease, meningitis generally does not occur. There is hypoglycemia with hyponatremia and hyperkalemia, and the ACTH stimulation test demonstrates the acute adrenal failure. Leukocytosis need not to be extreme and in fact leukopenia may be seen and it is a very poor prognostic sign. C-reactive protein levels can be elevated or almost normal. Thrombocytopenia is sometimes extreme, with alteration in prothrombin time (PT) and partial thromboplastin time (PTT) suggestive of diffuse intravascular coagulation (DIC). Acidosis and acute renal failure can be seen as in any severe sepsis. Meningococci can be readily cultured from blood or CSF, and can sometimes be seen in smears of cutaneous lesions.

Causes - Waterhouse–Friderichsen syndrome

Escherichia coli Pneumococcus Neisseria meningiditis Neisseria gonorrhoea

Prevention - Waterhouse–Friderichsen syndrome

Not supplied.

Diagnosis - Waterhouse–Friderichsen syndrome

Not supplied.

Prognosis - Waterhouse–Friderichsen syndrome

Not supplied.

Treatment - Waterhouse–Friderichsen syndrome

Fulminant meningococcemia is a medical emergency and need to be treated with adequate antibiotics as fast as possible. Benzylpenicillin was once the drug of choice with chloramphenicol as a good alternative in allergic patients. Ceftriaxone is an antibiotic commonly employed today. Hydrocortisone can sometimes reverse the hypoadrenal shock. Sometimes plastic surgery and grafting is needed to deal with tissue necrosis. [edit]

Resources - Waterhouse–Friderichsen syndrome

Not supplied.
Currently no videos.
To submit one, CLICK HERE
Clinical Trials
No clinical trial found
Research Publications
No research publication found