Waterhouse-Friderichsen syndrome

Background

Etiology

• Infectious
  • Neisseria meningitidis (most common)
  • Pseudomonas aeruginosa
  • Streptococcus pneumoniae and other streptococci
  • Haemophilus influenzae
  • Staphylococcus aureus
  • Many others, in case reports, including viral causes
• Non-infectious risk factors include: anticoagulation, thrombocytopenia, HIT, APLA, trauma, postoperative

Epidemiology

• More common in children, but can happen at any age

Clinical Manifestations

• Shock
• Widespread purpura secondary to disseminated intravascular coagulation
• Rapidly-developing adrenal insufficiency from bilateral adrenal hemorrhage