Patient presents with acute (overnight) onset of command auditory hallucinations, hearing voices telling her scary things. No family history of mental illness; denies illicit drug use; no fever, cough, urinary urgency/frequency/dysuria. Physical exam completely negative, including neuro.
- Drug OD
- Urinary tract infection
What’s that, you say? Why yes, I’ve left out a key piece of information: the patient’s age. What would you think if the patient were 23? 33? 73?
As it happens, the patient was 73. The head CT was normal for age (no stroke; no tumor) and the diagnosis was UTI. Downright spooky what those things can do to the elderly.