Parthasarathi A, Sharma R, Weerakkody Y, et al. Waterhouse-Friderichsen syndrome. Reference article, Radiopaedia.org (Accessed on 25 Apr 2024) https://doi.org/10.53347/rID-12670
Waterhouse-Friderichsen syndrome, also known as purpura fulminans 9 or haemorrhagic adrenalitis 10, is characterised by adrenal insufficiency that results from atraumatic adrenal haemorrhage in consequence of septicaemia.
Waterhouse-Friderichsen syndromeis due to septicaemia and common infective agents include 5:
Neisseria meningitidis (meningococcus): classically-described cause
Haemophilus influenzae
Pseudomonas aeruginosa
Escherichia coli
Streptococcus pneumoniae
Radiographic features
Imaging features are often that of non-traumatic adrenal haemorrhage. The correct clinical context is vital in image interpretation.
History and etymology
It is named after Rupert Waterhouse, English physician (1873-1958) 8, and Carl Friderichsen, Danish paediatrician (20th century) 2. The latter reported his first 30 cases in 1918 10, writing a follow-up article in 1955 detailing another 250 cases 11!
6. Saad AF, Ford KL, Deprisco G et-al. Adrenomegaly and septic adrenal hemorrhage (Waterhouse-Friderichsen syndrome) in the setting of congenital adrenal hyperplasia. Proc (Bayl Univ Med Cent). 2013;26 (3): 268-9. Free text at pubmed - Pubmed citation