The Waterhouse-Friderichsen Syndrome

Abstract

THE Waterhouse-Friderichsen syndrome is a clinical entity first described in 1911 by Waterhouse¹ in an eight-month-old child. In 1918, Friderichsen² reviewed the literature and described a similar case with a fulminating course, characterized clinically by stupor, cyanosis, pallor, vomiting and a rapidly spreading purpuric eruption, and at autopsy by massive bilateral adrenal hemorrhages. This syndrome is associated with a bacteremia, the etiologic agent in the majority of cases being the meningococcus. Although the pneumococcus, hemolytic streptococcus and staphylococcus have also been inculpated, considerable doubt has been cast on the role of any of these organisms as the offending agent.