Waterhouse-Friederichsen syndrome (WFS) is a rare but life-threatening condition characterized by acute adrenal gland failure, often accompanied by severe bleeding into the adrenal glands. Named after the British pathologist Rupert Waterhouse and the Danish pediatrician Carl Friederichsen, who first described the syndrome in the early 20th century, WFS typically occurs as a complication of overwhelming bacterial infections.
The syndrome is caused by the destruction of the adrenal glands, which are responsible for producing essential hormones like cortisol and aldosterone. During WFS, bacterial toxins, most commonly from Neisseria meningitidis (meningococcus), invade and damage the blood vessels supplying the adrenal glands, leading to necrosis and bleeding. This catastrophic destruction of the adrenal tissue results in a sudden and severe impairment of hormone production, leading to adrenal insufficiency.
Symptoms of Waterhouse-Friederichsen syndrome often manifest abruptly and progress rapidly. Affected individuals may experience high fever, intense headache, lethargy, and general malaise. As adrenal insufficiency develops, signs such as low blood pressure, dizziness, rapid heartbeat, dehydration, and pale skin may arise. If left untreated, the syndrome can result in circulatory collapse, organ failure, and ultimately, death.
Immediate treatment of WFS involves hospitalization and administration of intravenous fluids, antibiotics, and corticosteroids to stabilize the patient and replace the absent adrenal hormones. Intensive care support and monitoring are required due to the life-threatening nature of the syndrome. With prompt medical intervention, the prognosis can significantly improve, although certain cases may still result in severe complications.
