RT Journal
A1 Meier DE
T1 PAin as a cause of agitated delirium
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD August 13
VO 172
IS 15
SP 1130
OP 1130
DO 10.1001/archinternmed.2012.2088
UL http://dx.doi.org/10.1001/archinternmed.2012.2088
AB 
An 85-year-old woman with multiple medical problems, including dementia, coronary artery disease, renal insufficiency, and peripheral vascular disease, was admitted to our hospital with urosepsis. Her hospital course was complicated by the development of dry gangrene of her left foot, Candida sepsis, Clostridium difficile enterocolitis, and multiple deep sacral and trochanteric pressure ulcers. When housestaff asked her son if he wanted us “to do everything,” he always answered yes. She was able to be weaned from the ventilator and was transferred to a medical unit for continued treatment of hospital-acquired C difficile enterocolitis and wound care of her multiple stage 4 ulcers. She underwent 4 surgical debridements under general anesthesia in the operating room over a several-month period but remained persistently febrile despite continuous treatment with broad spectrum antibiotics.