Waterhouse-Friderichsen Syndrome

Excerpt

Waterhouse-Friderichsen syndrome (WFS) is a rare clinical conundrum first described by Rupert Waterhouse and Carl Friderichsen as bilateral adrenal hemorrhage in the setting of bacterial sepsis among children in the first decade of the 20th century. Over the years, there have been reports of bilateral adrenal hemorrhage (AH) in association with multiple etiologies, including various systemic bacterial and viral infections. WFS has thus been used as a broader clinical term to address the adrenal insufficiency associated with bilateral adrenal hemorrhage. Although the adrenal insufficiency is mainly a feature in those with bilateral adrenal hemorrhage, there have been instances where the insufficiency occurred in unilateral hemorrhage. In these situations, the opposite adrenal gland was exhausted, i.e., the cortical lipoid was reduced or absent.