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Previous Volume 353:2820 December 29, 2005 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The article by Adem and colleagues (Sept. 22 issue)¹ described three patients with severe sepsis caused by Staphylococcus aureus who had, at autopsy, bilateral adrenal hemorrhage. Two of the patients had elevated serum cortisol levels. Is it possible that clinical deterioration was associated with a sudden decrease in the plasma cortisol level, which is expected after bilateral adrenal hemorrhage? In patients with severe sepsis, the use of corticosteroids may improve the clinical course. Current evidence suggests that corticosteroids improve outcome in adults for whom the results of a corticotropin stimulation test are abnormal (despite an elevated baseline . . . [Full Text of this Article]

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