This case of fulminating meningococcemia is reported because, despite a clinical course typical of acute adrenal failure due to hemorrhage into the adrenals (Waterhouse-Friderichsen syndrome), necropsy revealed focal necrosis of the pituitary and no definite alterations in the adrenal glands.
REPORT OF CASE
L. Z., a man aged 36, a physician, was admitted to the hospital on Dec. 2, 1942 with the chief complaints of malaise and headache of about twenty hours' duration.During the evening of the preceding day the patient began to have malaise, headache and occasional slight chills. He came to work next morning and performed a necropsy. He did not feel well and vomited after eating lunch; his temperature was 38.5 C. (101.3 F.). On returning home he felt progressively worse and was sent to the hospital.On examination the patient appeared acutely but not severely ill. The pulse rate was 96 and the respiratory rate 24
Gordon WH, Shimkin MB. FULMINATING MENINGOCOCCEMIA WITH PURPURA, MENINGITIS AND FOCAL NECROSIS OF PITUITARY. JAMA. 1943;123(3):147–148. doi:10.1001/jama.1943.82840380001007
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