Transient Waterhouse-Friderichsen Syndrome in a Child: A Case Report

Gian Luca Trobia, Federica Sullo, Maria Carla Finocchiaro, Eloisa Gitto, Carmen Damiano, Rita Maria Caccamo, Rosario Ranno, Vita Antonella Di Stefano


Waterhouse-Friderichsen syndrome (WFS) is a rare but usually fatal disease characterized by adrenal insufficiency associated to bilateral adrenal hemorrhage. It can be associated both to non-infection and a variety of infectious diseases, among which sepsis from Neisseria meningitidis accounts for more than 80% of cases. We report the case of an otherwise healthy 2-year-old child who had a WFS as a consequence of Neisseria meningitidis infection and in which we witnessed a complete recovery of adrenal function a few months after the event. The case highlights not only the difficulty of diagnosing this syndrome but also, at the same time, the extreme importance of high suspicion, early treatment, a multidisciplinary approach and, most of all, the importance of verifying the restoration of adrenal function in order to achieve a better quality of life.

Int J Clin Pediatr. 2021;10(1):28-33


Waterhouse-Friderichsen syndrome; Neisseria meningitidis; Adrenal insufficiency; Pediatric emergency room; Purpuric lesions; Fever

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International Journal of Clinical Pediatrics, quarterly, ISSN 1927-1255 (print), 1927-1263 (online), published by Elmer Press Inc.                     
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