Waterhouse-Friderichsen Syndrome

Waterhouse-Friderichsen syndrome is a relatively rare, but extremely serious complication of meningococcal infection. When the bacteria enter the bloodstream, they cause severe sepsis. The immune system reacts very violently with a extensive response, which may even worsen the overall situation. The condition may easily progress into a circulatory shock with multiple organ failure. The sepsis may even affect the adrenal glands causing bleeding into the glands and their failure. The bleeding into the glands is largely due to failure of blood clotting system.


The adrenal gland is a paired organ, which is located above the upper pole of each kidney. Adrenal glands produce a number of hormones, which are essential for metabolism of minerals, for maintaining glycemia and for coping with stressful situations.


The affected patients develop signs typical for meningococcal infection and symptoms of circulatory shock (see relevant article) with impaired consciousness, hypoglycemia and disruption of internal environment.


Treatment in the ICU ward is the only option. It is necessary to keep plenty of fluids in the blood vessels by using infusions, in case of need secure the airways and treat the patient with strong antibiotics. However, the mortality of this condition is very high even with maximal treatment.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources