Nor-epinephrine in the treatment of acute meningococcemia with shock (Waterhouse-Friderichsen syndrome) and an evaluation of adrenocortical function.

Abstract

BEFORE the advent of the sulfonamides, recovery from the Waterhouse–Friderichsen syndrome was rare.1 Thereafter, isolated case reports described successful treatment of this fulminating infection, and by 1948 Brand2 reviewed 25 cases with recovery and added 1 of his own. When penicillin and the sulfonamides were combined, the results in all types of meningococcal infections improved greatly3 4 5 6 7 8 9; however, many patients with the Waterhouse–Friderichsen syndrome continued to die in shock, despite the liberal use of antibiotic and chemotherapeutic agents. Vigorous adrenal substitution therapy, including parenteral administration of epinephrine, has been advocated by Thorn and his associates,10 and recently there have been . . .