This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Morton D. Grant, MD; Herbert I. Horowitz, MD; Victor Lorian, MD; Harold R. Brodman, MD

JAMA. 1970;212(8):1373-1374.

Abstract
A 54-year-old woman with a brief febrile illness presented with shock and ecchymoses. Coagulation studies demonstrated thrombocytopenia, hypofibrinogenemia, prolonged thrombin and prothrombin times, and circulating fibrin split products. The autopsy disclosed a pneumococcal bacteremia (with early changes suggesting pneumonia), bilateral hemorrhagic necrosis of the adrenals (the Waterhouse-Friderichsen syndrome) and a small previously infarcted spleen. A review of six previous reports of the Waterhouse-Friderichsen syndrome complicating pneumococcal bacteremia revealed splenic abnormalities in four. Splenic pathology and shock are suggested as important concomittants of this very rare complication of pneumococcal infection.

Author Affiliations
From the departments of pathology (Drs. Grant, Horowitz, and Lorian), medicine (Dr. Horowitz), and surgery (Dr. Brodman), The Bronx-Lebanon Hospital Center, New York.

Footnotes
Reprint requests to 1276 Fulton Ave, Bronx, NY 10456 (Dr. Horowitz).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Fulminant Pneumococcal Infections in 'Normal' Asplenic Hosts
Gopal and Bisno
Arch Intern Med 1977;137:1526-1530.
ABSTRACT  

Pneumococcal Bacteremia and Disseminated Intravascular Coagulation
Bisno
Arch Intern Med 1970;126:526-526.
ABSTRACT