{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T02:55:17Z","timestamp":1773284117902,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1995,8]]},"abstract":"<jats:p>Pasteurella multocida is an opportunistic pathogen causing bacteraemia in patients with liver dysfunction. A fulminant case of acute cholecystitis and septicaemia caused by P multocida, complicated by Waterhouse-Friderichsen syndrome without skin haemorrhage, is reported in a previously healthy 64 year old Chinese woman. The patient presented with a six hour history of sudden onset epigastric pain, vomiting, chills, and rigors. A presumptive diagnosis of cholangitis with septicaemic shock was made. Disease progression was rapid and the patient died within eight hours of symptom onset. This case is further proof that skin and mucosal haemorrhages are not an essential feature of Waterhouse-Friderichsen syndrome and this condition should be suspected in all patients presenting with sudden illness and fulminant septicaemia.<\/jats:p>","DOI":"10.1136\/jcp.48.8.775","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"775-777","source":"Crossref","is-referenced-by-count":21,"title":["Waterhouse-Friderichsen syndrome complicating primary biliary sepsis due to Pasteurella multocida in a patient with cirrhosis."],"prefix":"10.1136","volume":"48","author":[{"given":"M","family":"Ip","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J G","family":"Teo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A F","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3109\/00365548709021670","article-title":"Courtieu Waterhouse-Friderichsen syndrome complicating P multocida induced primary biliary sepsis A. 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Pasteurella multocida infections-report of 34 cases and review of the literature. Medicine 1984;63:133-54.","journal-title":"Medicine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/clinids\/18.5.842","article-title":"Pasteurella multocida sepsis after haemorrhagic shock in a cirrhotic patient: Possible role of endoscopic procedures and gastrointestinal translocation","volume":"18","author":"Brivet, F.; Guibert, M.; Barthelemy, P.; Lepicard, A.; Naveau, S.; Dormont, J.","year":"1994","unstructured":"Brivet F, Guibert M, Barthelemy P, Lepicard A, Naveau S, Dormont J. Pasteurella multocida sepsis after haemorrhagic shock in a cirrhotic patient: Possible role of endoscopic procedures and gastrointestinal translocation. 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