A 22-year old software engineer was brought in an unconscious state to the casualty. Clinical examination revealed features suggestive of shock, DIC and multisystem failure. CSF and petechial rashes yielded gram-negative diplococcic, which subsequently grew on modiefied Thayer-Martin medium. This isolation is known to be associated with-

Ans- A Waterhouse-Friderichsen Syndrome This uncommon but catastrophic syndrome is characterized by the following:An overwhelming bacterial infection, which is classically associated with Neisseria meningitidis septicemia but occasionally is caused by other highly virulent organisms, such as Pseudomonas species, pneumococci, Haemophilus influenzae, or staphylococciRapidly progressive hypotension leading to shockDisseminated intravascular coagulation with widespread purpura, particularly of the skinRapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage Whatever the basis, the adrenals are converted to sacs of clotted blood virtually obscuring all underlying detail.