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Delirium from infection — MCCQE Part 1 MCQ

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ModerateDeliriumDelirium from infectionMCCQE Part 1

An 84-year-old long-term care resident becomes acutely inattentive and disoriented over 24 hours. She has fever, suprapubic tenderness and new urinary frequency; collateral confirms she was normally oriented last week. Which of the following is the most likely diagnosis?

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Correct answer: A — Delirium precipitated by infection

Acute fluctuating inattention with altered cognition is delirium, and infection is a common precipitant in older adults. Dementia is chronic and progressive rather than abrupt over 24 hours, although it increases delirium risk. Canadian practice emphasizes identifying reversible causes, avoiding restraints where possible and using non-pharmacological orientation strategies.

Reference: Canadian Coalition for Seniors' Mental Health delirium guidance