Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. infection

Abstract

Objective: To describe a case of Waterhouse-Friderichsen syndrome of adrenocortical failure in a cat with Klebsiella spp. infection. Case Summary: A 12-year-old male neutered domestic short-haired cat was referred for respiratory failure requiring mechanical ventilation. The cat remained comatose despite successful weaning from the ventilator and developed a Klebsiella pneumoniae pneumonia. On day 4 of hospitalization, the cat acutely deteriorated with profound hypotension, azotemia, and hyperkalemia, which rapidly progressed to cardiac arrest. Necropsy findings revealed massive adrenal hemorrhage and intralesional bacteria, termed Waterhouse-Friderichsen syndrome. Waterhouse-Friderichsen syndrome was suspected to have been the cause of acquired adrenocortical insufficiency and sudden death of the cat. New or Unique Information:To the authors' knowledge, this is the first report of sepsis causing Waterhouse-Friderichsen syndrome in a veterinary species.

Ultrasonographic Detected Adrenomegaly in Clinically Ill Cats: A Retrospective Study

“…Next to stress of chronic illness, the differential diagnoses of adrenomegaly in cats include: adrenal cysts [6], hematomas [7,8], abscesses, granulomas [9][10][11], inflammation (adrenalitis) [7], hyperplasia (e.g., secondary to pituitary-dependent hypercortisolism, acromegaly or hyperthyroidism) [2][3][4][12][13][14][15][16][17], cortisol-secreting tumors [17,18], primary hyperaldosteronism [4,8,[19][20][21], sex hormone-producing neoplasia [22][23][24], pheochromocytoma [25,26], malignant lymphoma [27], metastasis [28,29], and amyloidosis of the adrenal glands [30].…”