3 weeks later, Mr. M is readmitted because of confusion and agitation. His family says that over the past few days he has fluctuated between being very sleepy and “hyper”; he is has been talking to people that are not in the room; and has taken very little in by mouth.
Physical exam:
In general, he is restless and cannot maintaining attention your interview. Vital signs: T 99, BP 100/50, pulse 105, O2 sat by pulse oximeter 89%. The remainder of the exam is notable for moderate abdominal distention with minimal tenderness in the lower abdomen. Other than his abnormal mental status, his neurologic exam is non-focal, although limited by his ability to follow instructions.
Your diagnosis: delirium