Postmortem measurement of serum procalcitonin concentration in Waterhouse-Friderichsen syndrome

Tsokos, Michael

doi:10.1007/s00428-002-0675-0

Cited by 14 publications

(7 citation statements)

References 16 publications

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“…The diagnosis of WFS is based on the following criteria: fulminant sepsis, skin patchy purpura, and bilateral hemorrhagic necroses of the adrenals [6,12]. The skin lesions, also known as "purpura fulminans" (PF) have an acute onset with cutaneous haemorrhage and necrosis [13,14].…”

Section: Discussionmentioning

confidence: 99%

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Postmortem detection of Neisseria Meningitidis in a case of Waterhouse- Friderichsen syndrome from fulminant meningococcal disease in an adult patient

Tattoli¹,

Marzullo²,

Vella³

et al. 2015

RJLM

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Waterhouse-Friderichsen syndrome (WFS) from meningococceal sepsis is a rare life-threatening condition which generally occur during infancy and childhood with a high mortality rate (from 10-30% up to 95%). It is very rare in the adult population, usually with pathological risk factors of invasive meningococcal infection. In such fatalities, the condition may rapidly progress into septic shock and disseminated intravascular coagulation with skin lesions (known as "purpura fulminans") and early recognition and therapy is often difficult owing to the unspecific findings at onset. The purpose of this case report is to present an unusual case of WFS from fulminant meningococceal disease with no meningeal involvement in a previously healthy adult patient, unexpectedly associated with dysmegakaryocytopoiesis findings in bone marrow. The conclusive diagnosis was due to the detection of Neisseria Meningitidis in cerebrospinal fluid despite a postmortem interval of four days and the long cadaver refrigeration.

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Section: Discussionmentioning

confidence: 99%

“…NM can ultimately origins a meningococcal sepsis with Waterhouse-Friderichsen syndrome (WFS), a rare and life-threatening condition which may occur during infancy and childhood [6] but is even more uncommon in adults [5].…”

mentioning

confidence: 99%

Postmortem detection of Neisseria Meningitidis in a case of Waterhouse- Friderichsen syndrome from fulminant meningococcal disease in an adult patient

Tattoli¹,

Marzullo²,

Vella³

et al. 2015

RJLM

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“…A recent study (Tsokos et al [20,21]) has demonstrated that the relatively stable protein PCT can be used as a postmortem marker of sepsis using immunoluminometric assay (LUMItest 1 ; Immunoluminometric assay [ILMA], BRAHMS Diagnostica GmbH, GERMANY) in order to discriminate between septic and non-septic fatalities. According to this study, stable PCT-levels can be expected up to 140 h after death [20].…”

Section: Introductionmentioning

confidence: 99%

The use of rapid diagnostic test of Procalcitonin serum levels for the postmortem diagnosis of sepsis

Ramsthaler

Kettner

Mall

et al. 2008

Forensic Science International

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“…Waterhouse–Friderichsen syndrome (WFS) is a catastrophic sepsis1 with a higher incidence in children,2 - 4 and is usually associated with adrenal gland hemorrhage, which is considered-along with the disseminated intravascular coagulation (DIC)-as the most fearsome complication. Due to the fact that symptoms may be non-specific, the in-vivo diagnosis of adrenal gland hemorrhage is difficult to define5 and is usually identified at autopsy 1.…”

Section: Introductionmentioning

confidence: 99%

The importance of the postmortem interval for the diagnosis of Waterhouse Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases

et al. 2019

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The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis , which was accountable for Waterhouse–Friderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours.

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Postmortem measurement of serum procalcitonin concentration in Waterhouse-Friderichsen syndrome

Cited by 14 publications

References 16 publications

Postmortem detection of Neisseria Meningitidis in a case of Waterhouse- Friderichsen syndrome from fulminant meningococcal disease in an adult patient

Postmortem detection of Neisseria Meningitidis in a case of Waterhouse- Friderichsen syndrome from fulminant meningococcal disease in an adult patient

The use of rapid diagnostic test of Procalcitonin serum levels for the postmortem diagnosis of sepsis

The importance of the postmortem interval for the diagnosis of Waterhouse Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases

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