Waterhouse-Friderichsen's syndrome results from haemorrhage into the adrenal cortex during meningococcal septicaemia. The definition can be extended to include other infective agents.
It may occur in about 10% of patients with meningococcal infection, and is characterised by a rapidly deteriorating clinical course with hypotension, shock, extensive haemorrhage within the skin, coma and death. The progression is rapid and death usually occurs within hours of onset of symptoms. There may also be disseminated intravascular coagulation in patients with this syndrome.
If this condition is not treated promptly then mortality approaches 100%.
The treatment is as that for meningococcal infection, but with the addition of adrenal support with hydrocortisone, given intravenously in a dose of 200 mg per four hours.
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