title: Waterhouse-Friderichsen syndrome caused by Haemophilus influenzae type b in an immunocompetent young adult.
abstract: A previously healthy 19-year-old woman had a febrile illness with hypotension, progressive cyanosis, and an evolving petechial rash. Despite aggressive therapy in the face of shock and disseminated intravascular coagulation, the patient suffered a cardiac arrest and could not be resuscitated. Haemophilus influenzae type b was cultured from the blood and echovirus 30 from the cerebrospinal fluid post mortem. Fulminant H influenzae type b infection in an immunocompetent adult is rare but should be recognized as a possible cause of the Waterhouse-Friderichsen syndrome.
authors.affiliation: Division of Field Services, Centers for Disease Control, Atlanta, Ga.
authors.forename: W P
authors.initials: WP
authors.lastname: McKinney
authors.forename: R C
authors.initials: RC
authors.lastname: Agner
mesh_terms: D000328:Adult; D004457:Echovirus Infections / Q000150:complications; D029822:Enterovirus B, Human / Q000302:isolation & purification; D005260:Female; D006192:Haemophilus Infections / Q000150:complications*; D006193:Haemophilus influenzae / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D007108:Immune Tolerance; D008589:Meningococcal Infections / Q000209:etiology*; D018805:Sepsis / Q000150:complications*; D014884:Waterhouse-Friderichsen Syndrome / Q000209:etiology*