Abstract
To the Editor:— It is reported in an article by Bjorklund (Fulminant Meningococcus Infection with Purpura: Case With Recovery,Nord. med.49:571 [April 17] 1953; abstracted inJ. A. M. A.152:1671 [Aug. 22] 1953) that a 5-year-old girl, moribund for some hours after admission and with shock and postmortem-like lividity, recovered after the use of antibiotics (penicillin and sulfonamides), adrenal cortical extracts, desoxycorticosterone acetate, and vitamins C and K. Pretreatment studies and those carried out during the acute phase of the illness indicated a normal excretion of 17-ketosteroids and 11-oxysteroids. The normal values did not indicate marked, irreversible injury to the adrenal cortex. Many patients with the Waterhouse-Friderichsen syndrome, however, continue to die in shock, despite the liberal use of antibiotic and chemotherapeutic agents. Treatment of the peripheral vascular collapse during the first 24 to 48 hours remains the major therapeutic problem. Muhl has reported the successful
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