{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:34:49Z","timestamp":1787841289845,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:p>\n                    Waterhouse-Friderichsen syndrome is one of the fatal complications of meningococcal infection. Here we report a fatal case of this syndrome due to\n                    <jats:italic toggle=\"yes\">Neisseria meningitidis<\/jats:italic>\n                    in a 29-year-old male patient who was admitted with high-grade fever and chills and vomiting since 7 days, a skin rash over the abdomen and trunk, and altered sensorium since 2 days. On examination, the signs of meningitis were present along with the hemorrhagic rash. The diagnosis of adrenal hemorrhage was confirmed by computerized tomographic scan findings. The patient was started on intravenous ceftriaxone, and the cerebrospinal fluid was processed for bacterial culture, which yielded growth of\n                    <jats:italic toggle=\"yes\">N meningitidis<\/jats:italic>\n                    . The patient's condition deteriorated; he developed purpura along with a fall in platelet count, and died due to shock. This case is being reported as such a complication is comparatively rare in this antibiotic era, especially in adults, and starting steroids like dexamethasone prior to antibacterial therapy may be useful to diminish the inflammation brought about by bacterial cell death and thus help in reducing the otherwise high mortality in these cases.\n                  <\/jats:p>","DOI":"10.4103\/0019-5154.82496","type":"journal-article","created":{"date-parts":[[2011,6,30]],"date-time":"2011-06-30T00:54:09Z","timestamp":1309395249000},"page":"326-328","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["WATERHOUSE-FRIDERICHSEN SYNDROME IN AN ADULT PATIENT WITH MENINGOCOCCAL MENINGITIS"],"prefix":"10.4103","volume":"56","author":[{"given":"Alka","family":"Sonavane","sequence":"first","affiliation":[{"name":"Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasant","family":"Baradkar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Salunkhe","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250920","first-page":"23","article-title":"Invasive meningococcal disease in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia","volume":"52","author":"Raja","year":"2006","journal-title":"J Postgrad Med"},{"key":"R2-20250920","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0255-0857(21)02464-6","article-title":"Meningococcal disease: History, epidemiology, pathogenesis, clinical manifestation, diagnosis, antimicrobial susceptibility and prevention","volume":"24","author":"Manchanda","year":"2008","journal-title":"Ind J Med Microbiol"},{"key":"R3-20250920","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1056\/NEJMoa044194","article-title":"Staphylococcus aureus sepsis and Waterhouse Friedrichsen syndrome in children","volume":"353","author":"Adem","year":"2005","journal-title":"N Eng J Med"},{"key":"R4-20250920","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/S0140-6736(01)60988-7","article-title":"A case of suprarenal apoplexy","volume":"1","author":"Waterhouse","year":"1911","journal-title":"Lancet"},{"key":"R5-20250920","first-page":"1","article-title":"Meningococcal meningitis in Delhi and other areas","volume":"2","author":"Basu","year":"1985","journal-title":"Commun Dis Bull"},{"key":"R6-20250920","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1128\/CMR.13.1.144","article-title":"Update on meningococcal disease with emphasis on pathogenesis and clinical management","volume":"13","author":"Van Deuren","year":"2003","journal-title":"Clin Microbiol Rev"},{"key":"R7-20250920","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1136\/jcp.2003.9936","article-title":"Waterhouse Friedrichsen syndrome as a result of nonmenigococcal infection","volume":"57","author":"Hamilton","year":"2004","journal-title":"J Clin Pathol"},{"key":"R8-20250920","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.4065\/76.11.1167","article-title":"Waterhouse- Friedrichsen syndrome after infection with Group A streptococcus","volume":"76","author":"Karkouris","year":"2001","journal-title":"Mayo Clin Proc"},{"key":"R9-20250920","first-page":"561","article-title":"Waterhouse Friedrichsen syndrome","volume":"51","author":"Farber","year":"1944","journal-title":"Can Med Assoc J"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00076423-201156030-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:39Z","timestamp":1787838519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00076423-201156030-00019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2011]]}},"URL":"https:\/\/doi.org\/10.4103\/0019-5154.82496","relation":{},"ISSN":["0019-5154","1998-3611"],"issn-type":[{"value":"0019-5154","type":"print"},{"value":"1998-3611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]},"assertion":[{"value":"2009-11-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-07-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}