Delirium

Delirium is one of the organic mental disorders observed most frequently in hospitalized HIV-infected patients. The exact prevalence of delirium or acute organic brain syndrome in HIV is unknown. Patients with advanced systemic disease and dementia are at a high risk for delirium, the cause of which is often multifactorial. The precipitant organic factors involved are listed in TableZ

Table 2 Aetiology of delirium in HIV-infected patients

A conservative attitude has been recommended for the management of these conditions, with the use of low oral or intramuscular doses of neuroleptics, and correction of the organic disorders responsible for the development of disturbances in the level of consciousness. (13> However, other authors have postulated that patients suffering from delirium and agitation should be given high doses of neuroleptics—alone or in combination with lorazepam—in cases where quick control of the symptoms is vital.(l4> The efficacy of pharmacological interventions in patients with delirium is heightened if treatment is begun as soon as the first symptoms appear.

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