CASE REPORT
Fatal Waterhouse-Friderichsen syndrome due to Neisseria
meningitidis group B in a paediatric patient during
the phone consultation era
1
Department of Paediatrics with Children’s Intensive Care Unit, Regional Public Hospital, Świdnica, Poland
2
Clinical Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
Submission date: 2022-05-21
Final revision date: 2022-07-16
Acceptance date: 2022-08-10
Publication date: 2023-03-02
Pediatr Pol 2023;98(1):74-78
KEYWORDS
bacterial meningitispreventive vaccinationsinvasive meningococcal diseaseWaterhouse-Friderichsen syndrome
TOPICS
ABSTRACT
Owing to uncharacteristic initial symptoms and rapid progression, invasive meningococcal disease is still a challenge to diagnose and treat, even in high-income countries. Waterhouse-Friderichsen syndrome is a potentially fatal complication of invasive meningococcal disease, presenting as acute adrenal insufficiency due to haemorrhagic necrosis of the adrenal glands. We report a case of 5.5-year-old boy who presented to the hospital with fever, impaired consciousness, vomiting, and upper respiratory tract infection symptoms. Despite prompt diagnosis of invasive disease and adequate treatment, the patient died. We underline the need to increase parents’ knowledge and better access to vaccines against meningococci for Polish paediatric patients. Paediatricians and primary care physicians must remain alert and be ready to suspect invasive meningococcal disease in their patients.
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