Delirium DDx

Delirium – Differential Diagnosis

Common causes

• Infection
  • UTI
  • Pneumonia
  • Others
• Dementia
• Psychiatric disorders
• Drugs& Alcohol

Must Not Miss

• CVA / TIA
• Myocardial Infarction
• Sepsis& CNS infections
• Subdural haematoma
• Hypothermia
• ‘Metabolic disturbance’
  • Dehydration
  • Hypoxia
  • Hypoglycaemia
  • Hyperglycaemia/DKA
  • Electrolyte disturbance
  • Organ failure
• Acute urinary retention

Easily missed

• Medications
• Serotonin syndrome
• Constipation
• Vitamin deficiencies
• Thyroid disorders

Red flags

• Rapid deterioration
• Hypoxia (Dyspnoea, Cyanosis)
• Chest pain, Collapse
• Neurological deficit
• Seizures
• Fever
• Alcohol dependence
• Hallucinations
• Risk to self or others

Investigations to consider

• FBC, CRP/ESR
• U+Es, LFTs, TFTs, Bone profile,
• Serum glucose, B12 + Folate
• Troponin /cardiac enzymes
• Medication levels (e.g. Digoxin)
• Toxicology screen
• Urinalysis/culture
• ECG
• CXR
• CT scan
• MRI