A Simple Guide to Waterhouse-Friderichsen Syndrome, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Waterhouse-Friderichsen Syndrome, Diagnosis and Treatment and Related Diseases

Waterhouse-Friderichsen syndrome (WFS) is a cluster of symptoms happening from the failure of the adrenal glands to function normally as a effect of bleeding into the gland.

WFS are caused by serious infection with meningococcus bacteria or other bacteria, such as:
1. Group B streptococcus
2. Pseudomonas aeruginosa
3. Streptococcus pneumoniae
4. Staphylococcus aureus

Waterhouse-Friderichsen syndrome was first mentioned in cases of Neisseria meningitidis sepsis.

Over the years, several bacterial and viral causes have been linked, which are not limited to:
1. Streptococcus pneumonia
2. Hemophilus influenzae
3. Escherichia coli
4. Staphylococcus aureus
5. Group A beta-hemolytic Streptococcus
6. Capnocytophaga canimorsus
7. Enterobacter cloacae
8. Pasteurella multocida
9. Plesiomonas shigelloides
10. Neisseria gonorrhoeae
11. Moraxella duplex

Bilateral adrenal hemorrhage has also been mentioned with:
1. Rickettsia rickettsii
2. Bacillus anthracis
3. Treponema pallidum
4. Legionella pneumophila
5. Viral infections such as Cytomegalovirus, Parvovirus B19, Epstein-Barr virus, and Varicella zoster virus

In children who died due to sepsis and bilateral adrenal hemorrhage, Pseudomonas aeruginosa was the most frequent pathogen diagnosed.

N. meningitidis is the most frequent bacteria linked with adrenal hemorrhage

Other risk factors linked with WFS are:
1. The use of anticoagulants,
2. Thrombocytopenia,
3. Hypercoagulable states as heparin-induced thrombocytopenia, and antiphospholipid syndrome,
4. Trauma to the adrenals,
5. Postoperative state.

Trauma was the documented cause of adrenal hemorrhage 2.8% patients.

2.1% patients had adrenal hemorrhage linked with anticoagulant therapy

Adrenal hemorrhage was not common (5.4%, n=6) as a complication of chronic anticoagulation in patients receiving warfarin alone without antiplatelet therapy.

Symptoms can happen suddenly.

They are caused by the bacteria growing (multiplying) inside the body.

Symptoms are:
1. Fever and chills
2. Joint and muscle pain
3. Headache
4. Vomiting

On abdominal examination, abdominal rigidity or rebound tenderness may be evident.

WFS linked with meningococcemia typically shows:
1. Petechial rash,
2. Disseminated intravascular coagulation,
3. Purpura fulminans

The petechial rash normally forms on the trunk and lower portions of the body but can form over mucous membranes as well.

If the doctor suspects the infection is produced by meningococcus bacteria, other tests are:
1. Lumbar puncture to get a sample of spinal fluid for culture
2. Skin biopsy and Gram stain test of sample

Patients with Waterhouse Friderichsen syndrome manifest with sepsis.

A blood sample is taken, and the treatment started instantly before obtaining the results.

Antibiotics are given right away to treat the bacterial infection.

Glucocorticoid medicines will also be given to treat any adrenal gland insufficiency.

Supportive treatments will be required for other symptoms.

Hypoglycemia is treatable by infusing 2 to 4 ml/kg of 25% dextrose as a bolus.

TABLE OF CONTENT
Introduction
Chapter 1 Waterhouse-Friderichsen Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Adrenal Hemorrhage
Chapter 8 Life and Death of an Adrenal Gland
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: May 31, 2021
• ISBN: 9781005902346

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Waterhouse-Friderichsen Syndrome,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Waterhouse-Friderichsen Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Waterhouse-Friderichsen Syndrome)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Waterhouse-Friderichsen syndrome

What is Waterhouse-Friderichsen syndrome?

Waterhouse-Friderichsen syndrome (WFS) is a cluster of symptoms happening from the failure of the adrenal glands to function normally as a effect of bleeding into the gland.

Alternative Names

Fulminant meningococcemia, Fulminant meningococcal sepsis, Hemorrhagic adrenalitis

Waterhouse-Friderichsen syndrome (WFS) is a rare medical disorder first reported by Rupert Waterhouse and Carl Friderichsen as bilateral adrenal hemorrhage in the situation of bacterial sepsis among children in the first decade of the 20th century.

Over the years, there have been records of bilateral adrenal hemorrhage (AH) in linkage with multiple causes, such as different systemic bacterial and viral infections.

WFS have been used to term the adrenal insufficiency linked with bilateral adrenal hemorrhage.

While the adrenal insufficiency is mostly a feature in those with bilateral adrenal hemorrhage, there have been cases where the adrenal insufficiency happened in unilateral hemorrhage.

The opposite adrenal gland was exhausted, i.e., the cortical lipoid was decreased or not present

What are the causes of Waterhouse-Friderichsen syndrome?

Causes

The adrenal glands are 2 triangle-shaped glands each sited on top of each kidney.

The adrenal glands produce different hormones that the body requires to function normally.

The adrenal glands can be affected by many disorders, such as infections like WFS.

WFS are caused by serious infection with meningococcus bacteria or other bacteria, such as:

1. Group B streptococcus

2. Pseudomonas aeruginosa

3. Streptococcus pneumoniae

4. Staphylococcus aureus

Waterhouse-Friderichsen syndrome was first mentioned in cases of Neisseria meningitidis sepsis.

Over the years, several bacterial and viral causes have been linked, which are not limited to:

1. Streptococcus pneumonia

2. Hemophilus influenzae

3. Escherichia coli

4. Staphylococcus aureus

5. Group A beta-hemolytic