Wu Meng-Yu, Chen Chien-Sheng, Tsay Chih-Yi, Yiang Giou-Teng, Ke Jian-Yu, Lin Po-Chen
Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.
Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan.
Brain Sci. 2020 Mar 17;10(3):171. doi: 10.3390/brainsci10030171.
-induced acute systemic meningococcal disease is an emergency and a fatal condition that has a high mortality rate. In patients with a fulminant infection, a maculopapular petechial eruption, purpura fulminans, or an ecchymotic lesion are worrisome signs reflecting disseminated intravascular coagulation (DIC) and hint at Waterhouse-Friderichsen syndrome (WFS). Here, we describe a rare case of a patient with a fulminant induced acute systemic meningococcal disease presenting with high-grade fever without meningitis symptoms. Fatal septicemia with DIC and multiple organ failure was noted. WFS was chiefly suspected. We highlight the clinical features and pathogenesis of -induced meningococcemia and WFS. We propose that they should be kept in mind, especially in patients presenting with a petechial eruption and purpura fulminans.
诱发的急性全身性脑膜炎球菌病是一种紧急且致命的疾病，死亡率很高。在暴发性感染患者中，斑丘疹瘀点疹、暴发性紫癜或瘀斑病变是令人担忧的体征，反映了弥散性血管内凝血（DIC），提示存在华-佛综合征（WFS）。在此，我们描述了一例罕见病例，一名患者患有暴发性诱发的急性全身性脑膜炎球菌病，表现为高热但无脑膜炎症状。发现有致命性败血症伴DIC和多器官功能衰竭。主要怀疑为WFS。我们强调了诱发的脑膜炎球菌血症和WFS的临床特征及发病机制。我们建议应予以重视，尤其是对于出现瘀点疹和暴发性紫癜的患者。
