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Waterhouse-Friderichsen syndrome

Definition

Waterhouse-Friderichsen syndrome is failure of the adrenal gland due to bleeding into the gland.

Causes

This condition is caused by severe infection with meningococcus bacteria or other severe infection from bacteria, such as:

  • Group B streptococcus
  • Pseudomonas aeruginosa
  • S. pneumoniae
  • Staphylococcus aureus

Rarely, Waterhouse-Friderichsen syndrome can be caused by the use of medications that promote blood clotting, including heparin. Other causes include:

  • Low platelet counts
  • Primary antiphospholipid syndrome
  • Renal vein thrombosis
  • Steroid use

Possible Complications

Complications include:

  • Acute adrenal gland insufficiency
  • Shock

It is deadly if not treated right away.

References

Meurer WJ, Lavoie FW. Central nervous system infections. In: Marx JA, Hockberger Rs, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 107.

Maitra A. The endocrine system. In: Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 24.

White PC. Adrenocortical insufficiency. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 569.

Review Date: 8/24/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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