22nd August 2024

An 84-year-old man is admitted to A&E with delirium presumed secondary to a urinary tract infection

An 84-year-old man is admitted to A&E with delirium presumed secondary to a urinary tract infection. He suffered a significant stroke six months previously resulting in hemiparesis. He was managed on the rehabilitation ward prior to discharge to a nursing home and is now wheelchair bound, often opting to sleep in his chair rather than use the hoist to transfer. He has also been incontinent of urine since the stroke. He has a background of diabetes, hypertension, atrial fibrillation, chronic kidney disease and a previous below knee amputation. On examination, you see a wound over the sacrum in which there is full thickness loss of skin and believe that the bone beneath the lesion is visible. Bloods demonstrate a raised white cell count and c-reactive protein. What investigation would be most appropriate in further investigating the delirium?

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