Agrawal Abhinav, Jasdanwala Sarfaraz, Agarwal Abhishek, Eng Margaret
Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.
Department of Internal Medicine, Cooper University Hospital, Camden, New Jersey, USA.
BMJ Case Rep. 2014 Sep 29;2014:bcr2014206295. doi: 10.1136/bcr-2014-206295.
Waterhouse-Friderichsen syndrome (fulminant meningococcaemia) is a fulminating infection, often leading to mortality in a matter of hours. In the past 3 years there has been a rise in cases of Neisseria meningitis in the men who have sex with men (MSM) population in the USA and sporadic cases over the world especially in those who are HIV positive. We describe a case of a 34-year-old Caucasian man who presented with acute fulminant meningococcaemia, which proved fatal over a period of hours. This case report emphasises the need for further vigilance, prompt diagnosis and treatment of fulminant meningococcaemia without signs of meningitis especially in the MSM population and the need to expand vaccination recommendations of Meningococcaemia in the MSM population across the USA in both HIV positive and negative males.
华-佛综合征（暴发性脑膜炎球菌血症）是一种暴发性感染，常导致数小时内死亡。在过去3年中，美国男男性行为者（MSM）人群中脑膜炎奈瑟菌病例有所增加，世界各地也有散发病例，尤其是在HIV阳性者中。我们报告一例34岁白人男性，表现为急性暴发性脑膜炎球菌血症，数小时内死亡。本病例报告强调，对于无脑膜炎体征的暴发性脑膜炎球菌血症，尤其是在MSM人群中，需要进一步提高警惕、及时诊断和治疗，同时有必要扩大美国MSM人群中无论HIV阳性还是阴性男性的脑膜炎球菌血症疫苗接种建议范围。
