This syndrome is defined by rapidly developing adrenocortical insufficiency, which is caused by massive hemorrhage. Patients typically show hypoglycemia, hyponatremia and hyperkalemia, along with adrenal failure in the ACTH stimulation test.
Waterhouse-Friderichsen syndrome involves massive adrenal hemorrhage, which often occurs bilaterally. This hemorrhagic adrenalitis is typically caused by tubercular infection of the adrenal glands by the bacterium Neisseria meningitidis.
As a combined result of 1º adrenal failure and massive hemorrhage, patients display hypotension, which can rapidly progress to septic shock.
Neisseria meningitidis is a common cause and association with Waterhouse-Friderichsen Syndrome (WFS), as it can acutely and selectively effect the adrenals. Pseudomonas, Haemophilus and Staphylococcus auerus can also be associated with WFS.
Disseminated Intravascular Coagulation (DIC) is another common association with Waterhouse-Friderichsen Syndrome (WFS). Patients develop purpura and petichiae, and can display alterations of PT and PTT, further suggesting DIC with this syndrome.
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