Other symptoms that may also present are malodorous and cloudy urine, rigors, pyrexia (fever), nausea and an acute confusional state (Mahaffey, 2006). The presence of bacteria in the urine, also referred to as bacteriuria, can often lead to inappropriate antibiotic treatment — bacteriuria alone is rarely an indication for antibiotic treatment (SIGN, 2012). The diagnosis of UTI should be primari...

The abrupt onset of CNS symptoms in SLE patients presents a diagnostic and therapeutic challenge. As reported on a recent review of 323 SLE patients, the most common CNS presentations in descending order of frequency were headache, cerebrovascular disease, mood disorders, cognitive dysfunction, seizures, psychosis, anxiety disorder, and acute confusional state. [2] These symptoms may be either ...

BACKGROUND Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations. RESULTS We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy. CONCLUS...

A thiamine deficient patient presented to the emergency department with an acute confusional state, becoming unconscious and hypotensive following the administration of 32 g of intravenous glucose over 4 hr. A dramatic clinical improvement in his cardiovascular and neurological status followed a single intra-venous dose of 250 mg of thiamine. Profound thiamine deficiency was confirmed on bioche...