Resumo

BELTRAN, C.M.; PEREZ-JORGE, P.J.  e  FERNANDEZ-RODRIGUEZ, A.. Sudden death from meningococcal sepsis: postmortem diagnosis. Cuad. med. forense [online]. 2014, vol.20, n.4, pp.201-205. ISSN 1988-611X.  https://dx.doi.org/10.4321/S1135-76062014000300006.

The most common presentation of meningococcal disease is meningitis, with an incidence rate of 0.92 per 100,000 inhabitants and a mortality rate of 40.3% in Spain. Meningeal disease may present with nonspecific symptoms such as headache, among others, sometimes progressing rapidly to a fatal outcome before the patient receives adequate medical care. Besides classical meningitis, Neisseria meningitis produces a systemic disease that includes meningococcal sepsis and disseminated intravascular coagulopathy. In patients with meningococcal sepsis the Waterhouse-Friderichsen syndrome is described, which is characterized by bilateral adrenal hemorrhage, intravascular coagulation and shock liver, producing a severe bacteremia. This combination causes a fulminant shock and, if untreated, it may cause sudden death. We report the case of a female patient with sore throat, fever, vomiting and diarrhea of 24 hours of evolution. Despite receiving inpatient and outpatient medical care, she died as a result of N. meningitidis fulminant sepsis and clinically undiagnosed Waterhouse-Friderichsen syndrome.

Palavras-chave : Sudden death; Waterhouse-Friderichsen syndrome; Meningococcal sepsis; Postmortem microbiology; Neisseria meningitidis.

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