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Waterhouse-Friderichsen syndrome

Waterhouse-Friderichsen syndrome is failure of the adrenal gland to function as as result of bleeding into the gland.


This condition is caused by severe infection with meningococcus bacteria or other severe infection from bacteria, such as:

  • Group B streptococcus
  • Pseudomonas aeruginosa
  • S. pneumoniae
  • Staphylococcus aureus

Rarely, Waterhouse-Friderichsen syndrome can be caused by the use of medications that promote blood clotting. Other causes include:

Possible Complications

Complications include:

It is deadly if the underlying cause of this syndrome is not treated right away.


Meurer WJ, Lavoie FW. Central nervous system infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009:chap 107.

Maitra A. The endocrine system. In: Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, PA: Saunders Elsevier; 2009:chap 24.

White PC. Adrenocortical insufficiency. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 569.

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Update Date 9/1/2013