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An Electron Miscroscope Study of a Case of Meningococcemia in Man

William Margaretten, MD; Ilona Csavossy; Donald G. McKay, MD
Am J Dis Child. 1967;114(3):268-277. doi:10.1001/archpedi.1967.02090240082005.
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ONE OF THE characteristics of fulminant meningococcal septicemia is the rapid onset of irreversible shock and death. In addition to the fulminant clinical course the disease has been of interest because it is associated with two unusual lesions in a significant proportion of cases. These are the purpuric skin lesions and hemorrhagic adrenal necrosis. Adrenal hemorrhage was originally considered to be the cause of shock and death in meningococcemia but, with the failure of corticosteroid replacement therapy, circulatory failure cannot be ascribed to adrenal insufficiency.1 In fact there may be no evidence of adrenal hemorrhage at postmortem examination, although the clinical course of the patient is characterized by irreversible shock. Ferguson and Chapman2 have reviewed the necropsy findings in 16 cases of meningococcemia. They noted the presence of diffuse thromboembolic lesions in many organs including the heart, kidneys, liver, and lungs, as well as the adrenal glands and

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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