A Case of Waterhouse-Friderichsen Syndrome by Fulminant Pneumococcal Infection with Hypoplastic Spleen and Diabetes Mellitus

FUKAMITSU Gaku, KOGA Mayumi, KAWAOKA Toru, ARIYOSHI Kunio, ISHIHARA Tokuhiro, ODA Rie

doi:10.2342/ymj.58.105

Bibliographic Information

Other Title

脾臓低形成・糖尿病例に発症した劇症型肺炎球菌感染症によるＷａｔｅｒｈｏｕｓｅ‐Ｆｒｉｄｅｒｉｃｈｓｅｎ症候群の一例
ヒゾウテイケイセイトウニョウビョウレイニハッショウシタゲキショウガタハイエンキュウキンカンセンショウニヨル Waterhouse Friderichsen ショウコウグンノイチレイ
脾臓低形成・糖尿病例に発症した劇症型肺炎球菌感染症によるWaterhouse-Friderichsen症候群の一例

Search this article

Abstract

A 72-years old man suffered from diabetes mellitus visited and was admitted to our hospital because of fever, abdominal fullness and mild consciousness disturbance. The consciousness and respiratory condition worsened rapidly on the next day. Leukopenia, abnormal clotting parameter and low platelet count suggested the contraction of severe infection and disseminated intravascular coagulation (DIC). Despite of intensive care, he died in 24 hour after the admission. On microbiological investigation, Streptococcus pneumoniae was detected in his blood. The autopsy revealed a massive adrenal haemorrhage, aggregation of Gram positive bacteria without infiltration of neutrophils in multiple organ and hypoplasia of the spleen. Splenic dysfunction or diabetes mellitus is known as a risk factor of severe bacterial infection. This case of death was given as acute pneumococcal infection and adrenal haemorrhage result from the infection, which is usually regarded as Waterhouse-Friedrichsen syndrome. This is most frequently seen as a result of meningcocccal infection, it is seen in the case of other bacterial infection. This case is a rare report of Waterhouse-Friderichsen Syndrome induced from pneumococcal infection with hypoplastic spleen and diabetes mellitus.

Journal

Yamaguchi Medical Journal

Yamaguchi Medical Journal 58 (3), 105-110, 2009

Yamaguchi University Medical Association

Keywords

Details 詳細情報について

Export