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Neisseria meningitidis Induced Fatal Waterhouse–Friderichsen Syndrome in a Patient Presenting With Disseminated Intravascular Coagulation and Multiple Organ Failure

1
Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
2
Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
*
Authors to whom correspondence should be addressed.
Brain Sci. 2020, 10(3), 171; https://doi.org/10.3390/brainsci10030171
Received: 14 February 2020 / Revised: 13 March 2020 / Accepted: 15 March 2020 / Published: 17 March 2020
(This article belongs to the Special Issue Neurocritical Care and Cerebrovascular Health)
Neisseria meningitidis-induced acute systemic meningococcal disease is an emergency and a fatal condition that has a high mortality rate. In patients with a fulminant infection, a maculopapular petechial eruption, purpura fulminans, or an ecchymotic lesion are worrisome signs reflecting disseminated intravascular coagulation (DIC) and hint at Waterhouse–Friderichsen syndrome (WFS). Here, we describe a rare case of a patient with a fulminant Neisseria meningitidis-induced acute systemic meningococcal disease presenting with high-grade fever without meningitis symptoms. Fatal septicemia with DIC and multiple organ failure was noted. WFS was chiefly suspected. We highlight the clinical features and pathogenesis of Neisseria meningitidis-induced meningococcemia and WFS. We propose that they should be kept in mind, especially in patients presenting with a petechial eruption and purpura fulminans. View Full-Text
Keywords: Neisseria meningitidis; meningococcemia; Waterhouse–Friderichsen syndrome; disseminated intravascular coagulation; multiple organ failure Neisseria meningitidis; meningococcemia; Waterhouse–Friderichsen syndrome; disseminated intravascular coagulation; multiple organ failure
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MDPI and ACS Style

Wu, M.-Y.; Chen, C.-S.; Tsay, C.-Y.; Yiang, G.-T.; Ke, J.-Y.; Lin, P.-C. Neisseria meningitidis Induced Fatal Waterhouse–Friderichsen Syndrome in a Patient Presenting With Disseminated Intravascular Coagulation and Multiple Organ Failure. Brain Sci. 2020, 10, 171.

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