The Waterhouse-Friderichsen syndrome is a relatively rare, dramatically abrupt, fulminating condition in which there is massive, usually bilateral, adrenal hemorrhage associated with a striking, variegated cyanosis and acute cardiorespiratory collapse. The cause is generally considered to be meningococcic septicemia. Excellent discussions of the clinical picture have been presented by Aegerter,1 Sacks,2 Kunstadter3 and Lindsay, Rice, Selinger and Robins.4
Waterhouse5 in 1911 collected 15 cases from the literature, and Friderichsen6 in 1918 brought the total to 30 cases. The most recent review is that of Lindsay and his co-workers,4 who found 89 cases in the literature and added 7 of their own. Since that time 9 additional cases7 have been reported, bringing the total number of cases in the literature to 105. Practically all of these reports have come from Europe and the United States. Barsoum8 found this condition in an Egyptian