Pneumococcal Waterhouse-Friderichsen syndrome despite a normal spleen.
A previously fit 56 year old female presented with a rapidly progressive and fatal pneumococcal septicaemia with disseminated intravascular coagulation. Post-mortem studies confirmed a Waterhouse-Friderichsen syndrome and revealed an anatomically normal spleen; intracellular diplococci were seen within splenic macrophages providing evidence of normal splenic function. This appears to be only the second case of Waterhouse-Friderichsen syndrome due to pneumococcal septicaemia in a patient with a normal spleen.
Bramley
P N
PN
Department of Medicine, St. James's University Hospital, Leeds, UK.
Shah
P
P
Williams
D J
DJ
Losowsky
M S
MS
D005260:Female; D006801:Humans; D008589:Meningococcal Infections / Q000473:pathology*; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000150:complications / Q000473:pathology*; D018805:Sepsis / Q000150:complications / Q000473:pathology*; D013154:Spleen / Q000166:cytology*; D014884:Waterhouse-Friderichsen Syndrome / Q000209:etiology / Q000473:pathology*