We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |


Am J Dis Child. 1967;114(6):701-702. doi:10.1001/archpedi.1967.02090270157025.
Text Size: A A A
Published online


To the Editor.—The paper by Margaretten, Esavossy, and McKay, "An Electron Microscope Study of Meningococcemia in Man", (Amer J Dis Children114:268, 1967) is thought-provoking and should stimulate the clinician to regard the precise necessities of therapy in meningococcemia, a disease which varies so tremendously in expression. It is almost impossible to accept a single explanation for its capricious manifestations and to assume that all symptoms represent a single eponymic syndrome.

For many years fulminant meningococemia, with high mortality, was called Waterhouse-Fridericksen Syndrome. The use of this term has come to imply that adrenal hemorrhage and hypoadrenalism were responsible for shock and death. The lack of consistent autopsy evidence (adrenal hemorrhage is often lacking) and the suspicions of many clinicians were followed by definite evidence that plasma cortisol levels were only rarely decreased and that treatment with hydrocortisone, especially when given to the patient in whom only the


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.