{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T12:26:02Z","timestamp":1788006362762,"version":"build-2784847793"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"767","license":[{"start":{"date-parts":[[1989,9,1]],"date-time":"1989-09-01T00:00:00Z","timestamp":620611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1989,9,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>A previously fit 56 year old female presented with a rapidly progressive and fatal pneumococcal septicaemia with disseminated intravascular coagulation. Post-mortem studies confirmed a Waterhouse-Friderichsen syndrome and revealed an anatomically normal spleen; intracellular diplococci were seen within splenic macrophages providing evidence of normal splenic function. This appears to be only the second case of Waterhouse-Friderichsen syndrome due to pneumococcal septicaemia in a patient with a normal spleen.<\/jats:p>","DOI":"10.1136\/pgmj.65.767.687","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:05:27Z","timestamp":1230584727000},"page":"687-688","source":"Crossref","is-referenced-by-count":12,"title":["Pneumococcal Waterhouse-Friderichsen syndrome despite a normal spleen"],"prefix":"10.1093","volume":"65","author":[{"given":"P N","family":"Bramley","sequence":"first","affiliation":[{"name":"Departments of Medicine and Pathology, St. James\u2019s University Hospital , Beckett Street, Leeds LS9 7TF , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Shah","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pathology, St. James\u2019s University Hospital , Beckett Street, Leeds LS9 7TF , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J","family":"Williams","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pathology, St. James\u2019s University Hospital , Beckett Street, Leeds LS9 7TF , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Losowsky","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pathology, St. James\u2019s University Hospital , Beckett Street, Leeds LS9 7TF , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1989,9,1]]},"reference":[{"key":"ref_1","first-page":"57","article-title":"The syndrome of pneumococcemia, disseminated intravascular coagulation and asplenia","volume":"121","author":"Kingston, M.E.; MacKenzie, C.R.","year":"1979","unstructured":"Kingston, M.E. & MacKenzie, C.R. The syndrome of pneumococcemia, disseminated intravascular coagulation and asplenia. Can Med Assoc J 1979, 121: 57-61.","journal-title":"Can Med Assoc J"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.7326\/0003-4819-72-3-389","article-title":"The syndrome of asplenia, pneumococcal sepsis, and disseminated intravascular coagulation","volume":"72","author":"Bisno, A.L.; Freeman, J.C.","year":"1970","unstructured":"Bisno, A.L. & Freeman, J.C. The syndrome of asplenia, pneumococcal sepsis, and disseminated intravascular coagulation. Ann Int Med 1970, 72: 389-393.","journal-title":"Ann Int Med"},{"issue":"212","key":"ref_3","first-page":"1373","article-title":"Waterhouse-Friderichsen syndrome induced by pneumococcemic shock","volume":"1970","author":"Grant, W.D.; Horowitz, H.I.; Lorian, V.; Brodman, H.R.","unstructured":"Grant, W.D., Horowitz, H.I., Lorian, V. & Brodman, H.R. Waterhouse-Friderichsen syndrome induced by pneumococcemic shock. JAMA 1970, 212: 1373-1374.","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/0002-9343(74)90166-1","article-title":"Possible pathogenic role of capsular antigens in fulminant pneumococcal disease with disseminated intravascular coagulation","volume":"57","author":"Rytel, M.W.; Dee, T.H.; Ferstenfield, J.E.; Hensley, G.T.","year":"1974","unstructured":"Rytel, M.W., Dee, T.H., Ferstenfield, J.E. & Hensley, G.T. Possible pathogenic role of capsular antigens in fulminant pneumococcal disease with disseminated intravascular coagulation. Am J Med 1974, 57: 889-896.","journal-title":"Am J Med"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/65\/767\/687\/49244034\/postgradmedj-65-687.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/65\/767\/687\/49244034\/postgradmedj-65-687.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T18:02:40Z","timestamp":1681754560000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/65\/767\/687\/7044398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,9,1]]},"references-count":4,"journal-issue":{"issue":"767","published-online":{"date-parts":[[1989,9,1]]},"published-print":{"date-parts":[[1989,9,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.65.767.687","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1989,9]]},"published":{"date-parts":[[1989,9,1]]}}}