RT Book, Section A1 Bissonnette, Bruno A1 Luginbuehl, Igor A1 Engelhardt, Thomas SR Print(0) ID 1164087815 T1 Waterhouse-Friderichsen Syndrome T2 Syndromes: Rapid Recognition and Perioperative Implications, 2e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259861789 LK accesspediatrics.mhmedical.com/content.aspx?aid=1164087815 RD 2024/03/29 AB It is a medical condition characterized by fulminant clinical manifestation of bilateral adrenal hemorrhages as a result of pansystemic coagulopathy. The clinical features include: overwhelming organ failure, cardiovascular shock, disseminated intravascular coagulopathy, generalized purpura, adrenocortical insufficiency, and death if not treated immediately. The associated cyanosis, as a result of shock, is often extreme and often misleading of death condition. Major electrolyte disturbances, including severe hyperkaliemia and hypoglycemia require immediate attention. Leukopenia is considered a very poor prognostic sign. The association of extreme thrombocytopenia, prolonged prothrombin time (PT), and partial thromboplastin time (PTT) are suggestive of disseminated intravascular coagulopathy (DIC). It is caused by severe sepsis, classically meningococcemia (Neisseria meningitidis is the most common), but occasionally with other infections (influenza or colon bacillus). Prevention of the disease relates on routine vaccination against meningococcus, which is recommended by the Centers for Disease Control. It is highly recommended for all 11- to 18-year-olds and individuals with splenectomy, sickle-cell disease, and immunodeficiency.