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Pneumococcal Waterhouse-Friderichsen syndrome despite a normal spleen.
  1. P. N. Bramley,
  2. P. Shah,
  3. D. J. Williams,
  4. M. S. Losowsky
  1. Department of Medicine, St. James's University Hospital, Leeds, UK.


    A previously fit 56 year old female presented with a rapidly progressive and fatal pneumococcal septicaemia with disseminated intravascular coagulation. Post-mortem studies confirmed a Waterhouse-Friderichsen syndrome and revealed an anatomically normal spleen; intracellular diplococci were seen within splenic macrophages providing evidence of normal splenic function. This appears to be only the second case of Waterhouse-Friderichsen syndrome due to pneumococcal septicaemia in a patient with a normal spleen.

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