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1: N Engl J Med. 2005 Sep 22;353(12):1245-51.Click here to read Links
Comment in:
N Engl J Med. 2005 Dec 29;353(26):2820; author reply 2820.

Staphylococcus aureus sepsis and the Waterhouse-Friderichsen syndrome in children.

Adem PV, Montgomery CP, Husain AN, Koogler TK, Arangelovich V, Humilier M, Boyle-Vavra S, Daum RS.

Department of Pathology, University of Chicago, USA. patricia.adem@uchospitals.edu

Staphylococcus aureus has increasingly been recognized as a cause of severe invasive illness. We describe three children who died at our institution after rapidly progressive clinical deterioration from this infection, with necrotizing pneumonia and multiple-organ-system involvement. The identification of bilateral adrenal hemorrhage at autopsy was characteristic of the Waterhouse-Friderichsen syndrome, a constellation of findings usually associated with fulminant meningococcemia. The close genetic relationship among the three responsible isolates of S. aureus, one susceptible to methicillin and two resistant to methicillin, underscores the close relationship between virulent methicillin-susceptible S. aureus and methicillin-resistant S. aureus isolates now circulating in the community. Copyright 2005 Massachusetts Medical Society.

PMID: 16177250 [PubMed - indexed for MEDLINE]