FULMINATING MENINGOCOCCIC SEPTICEMIA ASSOCIATED WITH ADRENAL LESIONS

Abstract

FOR HALF a century reports have been appearing in the literature describing a febrile illness which was characterized by the sudden development of a state of shock, by the prominence of hemorrhagic cutaneous rashes, by the remarkably early fatal termination and by the finding of adrenal hemorrhages post mortem. Exceptionally cutaneous eruptions were lacking, and occasionally the adrenal glands were not hemorrhagic. Voelcker,1in 1894, was the first to describe this syndrome, followed by Waterhouse2in 1911 and Friderichsen3in 1918. In time, the term Waterhouse-Friderichsen came to be applied to any illness of this nature, and this term has now become firmly entrenched in the literature. In none of the cases reported by those authors was the cause of the disease discovered, but in 1916 Maclagan and Cooke4reported the occurrence of the syndrome in association with meningococcic meningitis. There have been reported to