{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T21:13:36Z","timestamp":1751404416739,"version":"3.40.4"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>Acute delirium is a commonly encountered problem in the intensive care unit (ICU), which has a myriad of causes and contributes to poor outcomes. We present the case of an alcoholic critically ill patient who developed prolonged acute ICU delirium wrongly diagnosed as sedation and alcohol withdrawal. Protracted vomiting, swallowing disorders and continuous aspirations prevented him from enteral feeding and discontinuation of mechanical ventilation. After several days, it became clear that the patient had been misdiagnosed. Fortunately, nystagmus and ophthalmoplegia then allowed the recognition of Wernicke\u2019s encephalopathy, confirmed by cerebral MRIs. After thiamine supplementation, his state improved but he was discharged only on day 32. Wernicke\u2019s encephalopathy is an acute reversible neuropsychiatric emergency, which is falsely considered as uncommon, and is largely misdiagnosed, especially in critically ill patients. Thiamine should be systematically given to all critically ill alcoholic patients, especially those with protracted vomiting.<\/jats:p>","DOI":"10.1136\/bcr.10.2008.1096","type":"journal-article","created":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T11:13:40Z","timestamp":1240917220000},"page":"bcr1020081096","source":"Crossref","is-referenced-by-count":3,"title":["Acute delirium in a critically ill patient may be a wolf in sheep\u2019s clothing: Figure 1"],"prefix":"10.1136","volume":"2009","author":[{"given":"Malcolm","family":"Lemyze","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Favory","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Mathieu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,4,28]]},"reference":[{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.14.1753"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.4.341"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.3","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(82)90145-9"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6852.517"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.5","first-page":"134","article-title":"The role of thiamine deficiency in alcoholic brain disease","volume":"27","author":"Martin","year":"2003","journal-title":"Alcohol Res Health"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.6","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/37.6.513"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.7","doi-asserted-by":"publisher","DOI":"10.1186\/cc3504"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.8","doi-asserted-by":"publisher","DOI":"10.1177\/0115426504019005511"},{"key":"2025042507492710000_2009.apr23_1.bcr1020081096.9","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.alcalc.a008400"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.10.2008.1096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T14:49:31Z","timestamp":1745592571000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.10.2008.1096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":9,"alternative-id":["10.1136\/bcr.10.2008.1096"],"URL":"https:\/\/doi.org\/10.1136\/bcr.10.2008.1096","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2009]]}}}