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Fatal Waterhouse-Friderichsen syndrome due to Serotype C Neisseria meningitidis in a young HIV negative MSM (men who have sex with men).
  1. Abhinav Agrawal1,
  2. Sarfaraz Jasdanwala1,
  3. Abhishek Agarwal2,
  4. Margaret Eng1
  1. 1Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
  2. 2Department of Internal Medicine, Cooper University Hospital, Camden, New Jersey, USA
  1. Correspondence to Dr Abhishek Agrawal, agarwal-abhishek{at}


Waterhouse-Friderichsen syndrome (fulminant meningococcaemia) is a fulminating infection, often leading to mortality in a matter of hours. In the past 3 years there has been a rise in cases of Neisseria meningitis in the men who have sex with men (MSM) population in the USA and sporadic cases over the world especially in those who are HIV positive. We describe a case of a 34-year-old Caucasian man who presented with acute fulminant meningococcaemia, which proved fatal over a period of hours. This case report emphasises the need for further vigilance, prompt diagnosis and treatment of fulminant meningococcaemia without signs of meningitis especially in the MSM population and the need to expand vaccination recommendations of Meningococcaemia in the MSM population across the USA in both HIV positive and negative males.

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