Waterhouse-Friderichsen syndrome
From Wikipedia, the free encyclopedia
| ICD-10 | E35.1, A39.1 |
|---|---|
| ICD-9 | 036.3 |
Waterhouse-Friderichsen syndrome is massive, usually bilateral, hemorrhage into the adrenal glands caused by fulminant meningococcemia. It is characterised by: (1) An overwhelming bacterial infection (2) Rapidly progressive hypotension leading to shock (3) DIC (disseminated intravascular coagulation) with widespread purpura, particularly of the skin (4) Rapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage.
Meningococcus is another term for the species Neisseria meningitidis, which is a cause of the type of meningitis which usually underlies this syndrome. This type of meningitis occurs most commonly in children and young adults, and can occur in epidemics. In the United States it is the cause of about 20% of meningitis cases. At one time it was common among military recruits, but administration of the preventive meningococcal vaccine has greatly reduced this number. Freshman college students living in dormitory housing who have not been vaccinated are another risk group.
Waterhouse-Friderichsen syndrome can also be caused by Streptococcus pneumoniae, a common bacterial pathogen typically associated with meningitis in the adult and elderly population.
Routine vaccination against meningococcus is recommended for people who have poor splenic function (who, for example, have had their spleen removed or who have sickle-cell anemia which damages the spleen), or who have certain immune disorders, such as complement deficiency.
The syndrome is named for Rupert Waterhouse (1873-1958), an English physician, and Carl Friderichsen (1886-1979), a Danish physician, who wrote papers on the syndrome, which had been previously described.
[edit] References
- Waterhouse R. A case of suprarenal apoplexy. Lancet 1911;1:577-578.
- Friderichsen C. Nebennierenapoplexie bei kleinen Kindern. Jahrb Kinderheilk 1918;87:109-125.
- Kumar, V. Abbas, A., Fausto, N, Robins and Coltran: Pathological Basis of Disease Philadelphia, Pennsylvania: Elsevier Inc., 2005
[edit] External links
- Whonamedit.com page on the eponym
