These adrenal glands came from a patient who presented with severe hypotension, abdominal pain, high fever, nausea and vomiting, and confusion. The clinical course was unfortunate, with falling hematocrit, progressive hyperkalemia and hyponatremia. Autopsy was done. The microbiology sent shows this:
Challenge: What is this syndrome called?First image shown under fair use, second image is in the public domain.
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Waterhouse-Friderichsen syndrome
Autopsy
This is Waterhouse-Friderichsen syndrome, bilateral adrenal hemorrhage classically caused by Neisseria meningiditis (but may be caused by other bugs). Note the adrenals are black-red from extensive hemorrhage.
Sources: UpToDate; library.med.utah.edu.
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