Fatal Waterhouse-Friderichsen syndrome in an adult due to serogroup Y Neisseria meningitidis .

Autor:	Carvalho R; Department of Infectious Diseases, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal ruben.melo.carvalho@gmail.com., Henriques F; Department of Intensive Care, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal., Teixeira S; Department of Intensive Care, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal., Coimbra P; Department of Intensive Care, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2021 Feb 04; Vol. 14 (2). Date of Electronic Publication: 2021 Feb 04.
DOI:	10.1136/bcr-2020-238670
Abstrakt:	Waterhouse-Friderichsen syndrome (WFS), defined as severe adrenal insufficiency due to bilateral adrenal gland haemorrhagic necrosis, occurred in a 59-year-old woman. An underlying serogroup Y Neisseria meningitidis (NM) infection was diagnosed, with a rapid progression to purpura fulminans, disseminated intravascular coagulation and WFS. Intensive treatment including fluid resuscitation, broad-spectrum antibiotic therapy, ventilatory support, platelet and factor replacement were administered. The meningococcaemia in the presence of WFS had a fulminant progression, leading to a fatal outcome within 24 hours of symptom onset. This case details the diagnosis and management challenges of the WFS, a rare complication of NM septicaemia, and describes the identification of a NM serogroup that is rare in Portugal in middle-aged patients. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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