title: Pneumococcal Waterhouse-Friderichsen syndrome despite a normal spleen.
abstract: 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.
authors.affiliation: Department of Medicine, St. James's University Hospital, Leeds, UK.
authors.forename: P N
authors.initials: PN
authors.lastname: Bramley
authors.forename: P
authors.initials: P
authors.lastname: Shah
authors.forename: D J
authors.initials: DJ
authors.lastname: Williams
authors.forename: M S
authors.initials: MS
authors.lastname: Losowsky
mesh_terms: 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*