Waterhouse-Friderichsen Syndrome

By | June 10, 2022

The Waterhouse-Friderichsen syndrome is a relatively rare disease, but poses an enormous threat to the life of those affected. For this reason, it is extremely important that – after the diagnosis – immediate intensive care treatment takes place.

What is Waterhouse-Friderichsen Syndrome?

The doctor describes as Waterhouse-Friderichsen syndrome a state of shock caused by bacterial toxins (toxins), which is primarily caused directly by the bacteria. Subsequently, there is an enormous consumption of coagulation factors (so-called consumption coagulopathy ), so that parts of the tissue (hemorrhagic necrosis ) of the adrenal cortex die off. For impulse control disorder overview, please visit homethodology.com.

The death causes bacterial blood poisoning (meningococcal sepsis). At the first sign of a possible Waterhouse-Friderichsen syndrome, a doctor must be contacted immediately. If treated too late or not at all, the mortality rate is 100 percent.


Waterhouse-Friderichsen Syndrome is caused by an enormous release of toxins; the toxins are produced by bacteria. The Waterhouse-Friderichsen syndrome is mainly caused by meningococci ; sometimes Haemophilus influenzae and pneumococci can also be responsible for the Waterhouse-Friderichsen syndrome.

Due to the release of toxins, the coagulation factors are subsequently activated. As a result, numerous thrombi form, which subsequently occlude the blood vessels. Massive bleeding also occurs; especially those in the skin, the internal organs and directly on the mucous membranes are visible. This loss of blood puts the patient in shock.

Endotoxin shock sometimes occurs as part of the Waterhouse-Friderichsen syndrome, which impairs the functions of the kidneys, adrenal glands, liver and lungs.

Symptoms, Ailments & Signs

Classic symptoms are massive bleeding directly into the skin ; the medical profession describes this condition as petechiae. In addition, intravital dead spots (livid, cold skin areas in which blood stagnates) and mucosal bleeding also occur.

As a result, the doctor also observes classic shock symptoms. The kidneys stop working ; the patient complains of very little or sometimes no urine output. Furthermore, those affected suffer from shortness of breath, so that the lungs subsequently fall into a state of shock. Yellowing of the patient appears ; this due to the liver having gone into shock.

As part of the Waterhouse-Friderichsen syndrome, the body gradually reduces the performance of the organs. If the thrombi move any cerebral vessels, neurological abnormalities occur. Mainly somnolence and cramps are possible. The symptoms of Waterhouse-Friderichsen syndrome usually appear within a few hours. At the first sign, a doctor must be contacted immediately!

Diagnosis & course of disease

The clinical picture is the most important indication that it could be a Waterhouse-Friderichsen syndrome. Waterhouse-Friderichsen Syndrome needs to be treated as soon as possible. Therefore, if any minor bleeding occurs and becomes visible on the skin, or diarrhea and fever occur, the patient should immediately be considered for Waterhouse-Friderichsen Syndrome.

At the first sign, a medical professional must be contacted immediately. The doctor detects an abnormality using different fibrinolysis and coagulation tests; numerous coagulation factors can be rated as massively consumed. There is also an enormous reduction in leukocytes (white blood cells); another indication is also reduced platelets.

Waterhouse-Friderichsen syndrome often ends in the patient’s death. If that person is treated too late or not at all, there is no chance of survival. For this reason, immediate medical help is essential.


Waterhouse-Friderichsen Syndrome is a life-threatening condition. If the condition is not treated promptly in intensive care medicine, serious complications can occur, including the death of the patient. The thrombi that occur as a result of the activated coagulation factors can cause blood to back up within the affected limb. If the clot advances to the lungs, a pulmonary embolism can occur.

Sepsis and/or permanent venous insufficiency can also occur. Furthermore, WFS can cause massive bleeding, which is associated with anemia and deficiency symptoms. Shock accompanies the loss of blood, combined with cardiovascular problems and other complications.

If a so-called endotoxic shock occurs, this can disrupt the functions of the internal organs and cause liver failure and a kidney infarction, for example. Due to the shortness of breath, the lungs can go into shock. In the final stages of the disease, neurological deficits, convulsions and strokes occur.

Drug therapy using cefotaxime and penicillin can cause side effects. Artificial ventilation carries the risk of developing respiratory infections. IV fluids, such as those used to provide fluids and nutrients, can also cause infections and other complications.

When should you go to the doctor?

With Waterhouse-Friderichsen syndrome, the person affected is always dependent on medical examination and treatment. Early detection and treatment of the disease always has a very positive effect on the further course and can prevent further complications and symptoms. Since self-healing is also not possible, the person affected should contact a doctor as soon as the first symptoms and symptoms of Waterhouse-Friderichsen syndrome appear. A doctor should be consulted if the affected person suffers from bleeding under the skin.

In most cases, the skin also appears very cold. Severe shortness of breath can also indicate Waterhouse-Friderichsen syndrome if it occurs for no particular reason and does not go away on its own. Yellowing of the skin can also indicate the disease and must be examined by a doctor immediately. If the syndrome causes acute and life-threatening symptoms, an ambulance should usually always be called or the hospital should be visited. In general, however, the disease can be detected by a general practitioner. The further treatment itself depends on the exact severity of the symptoms. The life expectancy of those affected is often limited by the Waterhouse-Friderichsen syndrome.

Treatment & Therapy

Therapy must be started as soon as possible. After the diagnosis, the doctor starts antibiotic therapy; as part of that, the attending physician uses the active ingredients cefotaxime and penicillin G. Those ensure that the infection is combated. Antibiotic treatment is therefore part of combating the causes of Waterhouse-Friderichsen syndrome.

In addition to antibiotic therapy, the physician must also treat the patient’s state of shock; in that case it is about combating the symptoms of the Waterhouse-Friderichsen syndrome. Combating the causes or symptoms alone will not lead to success. As part of the fight against symptoms, the doctor makes sure that he primarily treats the signs of shock.

First and foremost, this means that the person affected needs liquid, which must enter the body directly via the veins. In this way, the doctor can compensate for the patient’s lack of volume. The patient is then ventilated; This is the only way to balance the acid-base balance and the electrolyte balance.

Hydration and ventilation are the most necessary indications, increasing the patient’s chance of survival. If the doctor detects massive bleeding, fresh plasma and platelet concentrates can be administered. No other treatment options are currently available. The earlier the diagnosis is made, the better the patient’s chances of survival. If not treated in time, the syndrome ends in death.


So far there is no vaccine that prevents against the meningococcal group. This group is the main cause of the Waterhouse-Friderichsen syndrome. However, antibodies against the meningococci form later in life, so that the body is protected from an “invasion” of the bacteria. For this reason, the Waterhouse-Friderichsen syndrome occurs relatively rarely.

There is a vaccine against hemophilus influenza and pneumococci that can prevent Waterhouse-Friderichsen syndrome. This is a so-called 6-fold vaccine, which can be injected as early as the 3rd month of life. No other preventive measures are currently known.


In the case of Waterhouse-Friderichsen syndrome, the options and measures for direct follow-up care are in most cases significantly limited, although in some cases they are not even available to those affected. Therefore, the affected person should ideally consult a doctor at an early stage and also initiate treatment in order to prevent the occurrence of other symptoms and complications.

It cannot heal on its own, so the affected person is always dependent on treatment by a doctor. Therefore, a doctor should be consulted at the first sign. In most cases, Waterhouse-Friderichsen syndrome can be alleviated with physiotherapy or physiotherapy. Those affected can also carry out many of the exercises at home to prevent the occurrence of other complaints and to speed up healing.

Most follow-up care also includes taking various medications. Those affected should ensure that they take the medication regularly and also pay attention to the specified dosage in order to avoid any side effects. In many cases, the syndrome also limits the life expectancy of those affected.

You can do that yourself

Waterhouse-Friderichsen Syndrome represents a medical emergency. Self-help activities or measures are extremely minimal in these situations. The harmonious cooperation with an experienced team of doctors is extremely important for the relief of symptoms. The relationship of trust between doctor and patient must therefore be established and supported as best as possible.

Normally, the person concerned is not sufficiently responsive. Relatives are therefore responsible for making important decisions and taking the patient’s wishes into account. If there are open questions, they should be asked in order to be prepared for the situation and further development in the best possible way. In addition, in the case of knowledge deficits, the responsibility for obtaining information does not lie solely with the physician. At the same time, relatives should research and communicate closely with each other so that all those affected have the same level of knowledge.

Conflicts or interpersonal complications should be avoided at this stage. Since there is a risk of premature death, it is advisable to take appropriate precautions. According to current scientific knowledge, the patient’s chances of survival are very low. Therefore, if the relatives feel emotionally overwhelmed when coping with the circumstances, they should seek help. Otherwise, undesirable developments can occur that lead to problems later on.

Waterhouse-Friderichsen Syndrome