Fatal Waterhouse-Friderichsen syndrome due to Ewingella americana infection.

A fatal case of Waterhouse-Friderichsen syndrome resulting from infection in a previously healthy 74-year-old woman is reported. The patient died suddenly within 14 hours after presentation. The diagnosis of Waterhouse-Friderichsen syndrome as the cause of death was established post mortem based on autopsy findings, microscopic examination, measurement of serum procalcitonin concentration (113 ng/ml), and outcome of postmortem bacteriologic cultures that grew in heart and spleen blood samples. Since the introduction of as a new group in the family in 1983, more recent case studies have established its clinical significance and pathogenic potential to cause severe, life-threatening bacteremia and sepsis. is a rare pathogen that should be added to the list of unusual bacteria causing Waterhouse-Friderichsen syndrome.
AuthorsMichael Tsokos
JournalThe American journal of forensic medicine and pathology (Am J Forensic Med Pathol) Vol. 24 Issue 1 Pg. 41-4 (Mar 2003) ISSN: 0195-7910 [Print] United States
PMID12604997 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Protein Precursors
  • procalcitonin
  • Calcitonin
  • Aged
  • Calcitonin (blood)
  • Enterobacteriaceae (isolation & purification)
  • Enterobacteriaceae Infections (diagnosis, microbiology)
  • Fatal Outcome
  • Female
  • Heart (microbiology)
  • Humans
  • Protein Precursors (blood)
  • Spleen (microbiology)
  • Waterhouse-Friderichsen Syndrome (diagnosis, microbiology)

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