Острая надпочечниковая недостаточность и инфекционно-токсический шок как непосредственные причины смерти при менингококковой инфекции

Abstract

The purpose of the work is to clarify the criteria for the diagnosis of acute adrenal insufficiency and infectious-toxic shock as the direct causes of death in meningococcal infection. The study is based on a clinical and morphological analysis of 27 archival cases of fatal outcomes of patients with meningococcal infection. Histological examination of the archival preparations stained with hematoxylin and eosin was carried out. The specific volume of capillaries in the lungs, hemorrhages in the medullary and cortical substance of the adrenal glands, necrosis in the cortical and medullary layer of the adrenal glands, as well as preserved adrenal cells were studied quantitatively. According to the results of the study, in Waterhouse-Friderichsen syndrome, hemorrhages involving more than 1/3 of the adrenal cortex lead to fatal cases. In meningococcal infection with the development of infectious-toxic shock, capillaries occupy more than ½ of the volume of the interalveolar septa of the lung. The analysis of specific volumes of hemorrhages in the cortical substance of the adrenal glands and capillaries in the interalveolar septa of the lungs can be used during clinical and anatomical analysis for differential diagnosis of Waterhouse-Friderichsen syndrome and infectious-toxic shock.