22nd June 2023

A 19-year-old male presented to hospital with sudden onset headache with neck stiffness and photophobia.

A 19-year-old male presented to hospital with sudden onset headache with neck stiffness and photophobia. He was diagnosed with meningitis and started on IV antibiotics. Due to the severity of his disease, he later developed severe sepsis and disseminated intravascular coagulation, requiring admission to intensive care. Samples of CSF were positive for Neisseria meningitidis. During his admission on ITU, he is diagnosed with Waterhouse-Friderichsen syndrome and is started on appropriate treatment following this.

Which of the following renal tubular acidosis would be most associated with Waterhouse-Friderichsen syndrome?

Select the SINGLE most appropriate option from the list below. Select ONE option only.