Abstract
A 72-years old man suffered from diabetes mellitus visited and was admitted to our hospital because of fever, abdominal fullness and mild consciousness disturbance. The consciousness and respiratory condition worsened rapidly on the next day. Leukopenia, abnormal clotting parameter and low platelet count suggested the contraction of severe infection and disseminated intravascular coagulation (DIC). Despite of intensive care, he died in 24 hour after the admission. On microbiological investigation, Streptococcus pneumoniae was detected in his blood. The autopsy revealed a massive adrenal haemorrhage, aggregation of Gram positive bacteria without infiltration of neutrophils in multiple organ and hypoplasia of the spleen. Splenic dysfunction or diabetes mellitus is known as a risk factor of severe bacterial infection. This case of death was given as acute pneumococcal infection and adrenal haemorrhage result from the infection, which is usually regarded as Waterhouse-Friedrichsen syndrome. This is most frequently seen as a result of meningcocccal infection, it is seen in the case of other bacterial infection. This case is a rare report of Waterhouse-Friderichsen Syndrome induced from pneumococcal infection with hypoplastic spleen and diabetes mellitus.
