Autopsy of a 10-year-old child who died from Waterhouse-Friderichsen syndrome shows bilateral adrenal hemorrhagic necrosis. Which organism is the most common causative agent of this catastrophic complication?
- A Staphylococcus aureus
- B Pseudomonas aeruginosa
- C Neisseria meningitidis ✓
- D Haemophilus influenzae
Correct answer: C. Neisseria meningitidis
Explanation
Waterhouse-Friderichsen syndrome is characterized by bilateral massive adrenal hemorrhagic infarction occurring in the setting of overwhelming septicemia, classically caused by Neisseria meningitidis. The mechanism involves disseminated intravascular coagulation (DIC) and endotoxin-mediated vascular damage within the adrenal sinusoids. Acute adrenal insufficiency compounds the septic shock, leading to high mortality. Petechial and purpuric skin rash accompanies the meningococcemia.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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