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17th May 2025
You are asked to review a 96-year-old lady with new sudden onset confusion, agitation, hallucinations and delusions.
You are asked to review a 96-year-old lady with new sudden onset confusion, agitation, hallucinations and delusions. She was admitted for increased shortness of breath, productive cough, and increased oxygen requirement despite having home oxygen. She usually takes Amlodipine, Metformin modified release, Levemir 12 units before bed, Ipratropium inhalers, and Salbutamol inhalers.
Investigations:
| Haemoglobin | 146 g/L (130–180) |
| White cell count | 12.0 × 109/L (4.0–11.0) |
| Neutrophil count | 10.9 × 109/L (2.0–7.5) |
| Lymphocyte count | 2.1 × 109/L (1.0-4.0) |
| Eosinophil count | 0.10 × 109/L (0.04–0.40) |
| CRP | 86 (<2) |
| Serum sodium | 140 mmol/L (137–144) |
| Serum potassium | 3.6 mmol/L (3.5–4.9) |
| Serum urea | 3.0 mmol/L (2.5–7.0) |
| Serum creatinine | 125 μmol/L (60–110) |
| Serum random glucose | 4.1 mmol/L (4.0-6.0) |
| 12-lead ECG | Sinus tachycardia |
What is the most likely cause of her delirium?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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