A 19 year old college freshman is brought to the emergency department with fever, headache, vomiting, and confusion. He is hypotensive and has a diffuse petechial rash. Lumbar puncture is deferred due to instability. Blood cultures later grow oxidase positive gram negative diplococci that ferment maltose. Which of the following complications is most strongly associated with this infection?
- A)Aplastic crisis in a patient with sickle cell disease
- B)Ascending paralysis due to demyelination
- C)Parotitis with orchitis
- D)Bilateral adrenal hemorrhage leading to shockGABARITO
- E)Temporal lobe hemorrhagic necrosis
Explicação
Bilateral adrenal hemorrhage leading to shock is correct. Fulminant meningococcemia can cause Waterhouse Friderichsen syndrome, characterized by disseminated intravascular coagulation, petechiae, and adrenal hemorrhage. The dormitory setting and gram negative ... Ver explicação completa e trilha adaptativa →