Cause Analysis of 3 Misdiagnosed Cases of Autopsy-Proven Waterhouse-Friederichsen Syndrome
MU Jiao
QU Xi-liang
ZHANG Ji
DENG Jiao-juan
XIE Jing-ru
XU Ceng
ZENG Fei
DONG Hong-mei
Abstract：Objective To explore the key factors in diagnoses and treatment of Waterhouse-Friederichsen syndrome to avoid misdiagnosis and mistreatment. Methods The clinical and autopsy data of 3 cases of Waterhouse-Friederichsen syn-drome in the Department of Forensic Medicine, Tongji Medical College were reviewed. Results 2 cases presented with pete-chiasis or ecchymosis, and both were misdiagnosed as allergic purpura and anaphylactic shock. However, cough, asthma and dyspnea were complained as main clinical manifestations in 1 case, which was misdiagnosed as respiratory tract infection. All the patients with acute onset died soon. The forensic pathological diagnosis was acute adrenal function failure ( Waterhouse-Friederichsen syndrome) due to epidemic meningitis in 2 cases and acute adrenal function failure ( Waterhouse-Friederichsen syndrome) in 1 case. Conclusion This disease is rare, rapidly progressive and tends to be misdiagnosed. When diagnosis of Waterhouse-Friederichsen syndrome is definite, the patient should be treated as soon as possible. The effective strategy for treatment would be anti-coagulation with Heparin and anti-fibrinolytic drug and anti-shock remedy.
Keywords：Waterhouse-friederichsen syndromeRenal insufficiencyDiagnostic errorPurpuraschoenlein-he-nochShockRespiratory tract infection
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 71-73 )