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Confusion and lethargy in a 48 year old man

¹ Department of Gastroenterology, Belfast City Hospital, Northern Ireland, UK
² Departments of Histopathology, Belfast City Hospital, Northern Ireland, UK

Correspondence to:
Correspondence to:
Dr Simon Johnston
Level 6, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, Northern Ireland, UK; simon.johnston@bch.n-i.nhs.uk

Submitted 20 March 2003
Accepted 7 May 2003

The first 150 words of the full text of this article appear below.

A 48 year old retired fireman was admitted with a one week history of confusion, lethargy, and generalised weakness. This was associated with a non-productive cough for which he had been prescribed oral amoxycillin. He had a history of hypertension and was on lisinopril 20 mg daily. He was a smoker of 30 pack years and consumed 30 units of alcohol per week.

On admission his temperature was 37.7°C, pulse rate 100 beats/min, and blood pressure 80/40 mm Hg. He was clinically dehydrated, but otherwise clinical examination did not reveal any abnormalities. His mini-mental score was 8/10.

On admission, initial investigations revealed a haemoglobin concentration of 142 g/l and white cell count 5.5 x 10⁹/l with a normal differential white cell count. Prothrombin time was 16.2 seconds (control 12 seconds). Biochemical tests revealed evidence of renal impairment with urea 43.4 mmol/l, creatinine 416 µmol/l, sodium 128 . . . [Full text of this article]

Relevant Article

Confusion and lethargy in a 48 year old man
Postgrad. Med. J. 2004 80: 244-245. [Extract] [Full Text] [PDF]