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  • Title: Fatal Waterhouse-Friderichsen syndrome in an adult due to serogroup Y Neisseria meningitidis.
    Author: Carvalho R, Henriques F, Teixeira S, Coimbra P.
    Journal: BMJ Case Rep; 2021 Feb 04; 14(2):. PubMed ID: 33541984.
    Abstract:
    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.
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