[Cerebral imaging in a delirious patient]

Abstract

An 80-year-old woman attended the emergency department with sub-acute confusion and fever. On examination no focal signs were found. Cerebral CT showed an area of hypodensity suspected to be an infarction, but an MRI scan carried out 10 days later showed cerebral abscesses caused by a dental infection that had occurred four weeks previously. This case report shows that even if a patient with confusion does not show focal signs on examination, an organic brain disease - such as cerebral abscess - may still be present. Hence, when confusion is associated with fever or impaired consciousness, an MRI scan should be carried out.