Weight of clinical evidence at the present time favors the combined use of appropriate chemotherapy, vasopressors, and intravenously given adrenal steroids in all cases of fulminating meningococcemia. Reports appear to indicate that there is increased peripheral utilization of steroids in these patients. Review of the literature reveals no consistent picture so far as adrenal hemorrhage is concerned. Combined use of sulfisoxazole or sulfadiazine and intravenously given arterenol and hydrocortisone represents the therapy of choice.
Berkson DM, Perlman L, Miller AJ. FULMINATING MENINGOCOCCEMIA (WATERHOUSEFRIDERICHSEN SYNDROME): REPORT OF TWO PATIENTS SUCCESSFULLY TREATED WITH CHEMOTHERAPY, VASOPRESSORS, AND ADRENAL STEROIDS. JAMA. 1959;170(12):1387–1390. doi:10.1001/jama.1959.03010120023007
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