A Case of Waterhouse-Friderichsen Syndrome Resulting from an Invasive Pneumococcal Infection in a Patient with a Hypoplastic Spleen

Figure 2

Autopsy analysis. (a) Gross inspection of the entire body revealed purpura fulminans in the face, neck, and chest. (b) Macroscopic analysis of the spleen. The spleen weighted 20 g, with a size of 7.5 × 4.0 × 1.8 cm. (c) Microscopic analysis of the spleen revealed striking neutrophil infiltration. This finding was compatible with acute splenitis, showing evidence of sepsis. (d) Microscopic analysis of the adrenal glands demonstrated hemorrhage in all the layers of the cortex and medulla. Hemosiderin dispositions are apparent. (e, f) Microscopic analysis of the tonsils (e) and lungs (f) revealed streptococci (gram staining).

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