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Endocrine Abstracts (2018) 56 P35 | DOI: 10.1530/endoabs.56.P35

Adrenal cortex (to include Cushing's)

A four months infant survival case of waterhouse–friderichsen syndrome

Laura Teodoriu1, Danut Teodor2, Maria-Christina Ungureanu1,2, Letitia Leustean1,2, Bianca Ioan1 & Cristina Preda1,2


1Emergency Hospital ‘St. Spiridon’, Iasi, Romania; 2University of Medicine and Pharmacy ‘Grigore T. Popa’, Iasi, Romania.

Introduction: The Waterhouse–Friderichsen syndrome is a fulminating infection, often leading to mortality in a matter of hours by producing acute adrenal insufficiency (adrenal hemorrhage) at a time when their response is crucial to address acute stress.

Case report: We present the case of a 4 months boy with high fever 40 °C, vomiting, diarrhea, lethargy, maculopapular rash followed by petechiae and purpura. Biological tests revealed important leukocytosis and thrombocytopenia. Gram staining of cerebrospinal fluid pointed out gram-negative diplococci and latex agglutination testing was positive for type B meningococcal infection. With Glasgow Coma Scale of four the patient was admitted in the Intensive Care Unit and the evolution was positive with biological and clinical resolution after 14 days. ACTH 209 pg/ml (0–46 pg/ml) and cortisol 4.3 μg/dl (5–25 μg/dl) outlined the adrenal insufficiency.

Conclusion: Despite the high mortality rate (55–60%) our patient survived due to fast and accurate diagnosis. The incidence of Waterhouse–Friderichsen syndrome in Romania is 5.88/year/100,000 population aged 0–2 years, more frequent in countryside area males with poor socio-economically status as our patient’s case.

Key words: Waterhouse–Friderichsen syndrome, meningococcaemia, infant.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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