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April 1967

Hypofibrinogenemia and Thrombocytopenia With Meningococcemia

Am J Dis Child. 1967;113(4):494-497. doi:10.1001/archpedi.1967.02090190140020

SEVERE coagulation disorders in the course of meningococcal sepsis have been reported only sporadically, although petechial and purpuric lesions occur in one half of the clinical cases.1 Von Rechenberg2 stated that incoagulable blood does occur in fulminant meningococcemia; and Koller3 described a case in which hypofibrinogenemia, a deficiency in blood-clotting factor V, and thrombocytopenia were demonstrated. There have been occasional other reports of meningococcemia with prolonged bleeding and clotting times, thrombocytopenia, and associated factor V or VIII deficiences.4-7 A case of Waterhouse-Friderichsen syndrome due to pneumococcal septicemia, with incoagulable blood and multiple coagulation factor deficits, including hypofibrinogenemia and a circulating anticoagulant, has been reported by Ratnoff and Nebehay.8 Rodriguez-Erdman has recently suggested the name consumption-coagulopathy to describe similar clinical conditions.9

This is a report of a fatal case of fulminant meningococcemia, accompanied by hypofibrinogenemia, thrombocytopenia, and incoagulable blood. No fibrinolysins or antithrombin substances were