These adrenals are black-red from extensive hemorrhage in a patient with meningococcemia. This produces the Waterhouse-Friderichsen syndrome.
Waterhouse-Friderichsen syndrome Adrenals
Hemorrhage Adrenal
Adrenal gland massively replaced by hemorrhage. There was no evidence of a tumor in any of the many sections taken.Acute adrenal insufficiency caused by severe bilateral adrenal hemorrhage in an infant with overwhelming sepsis (Waterhouse-Friderichsen syndrome). At autopsy the adrenals were grossly hemorrhagic and shrunken; microscopically, little residual cortical architecture is discernible.
Adrenal hemorrhage