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A 26-year-old woman is brought in by her distraught husband. She has been un...

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A 26-year-old woman is brought in by her distraught husband.

She has been unwell for the last 3 days. She is intermittently confused and

over the last 24 hours, has refused to eat or drink and appeared to be

disengaged and cannot look after her 1- and 3-year-old children. She has no regular medications. The only sick contact is one of her children who had a diarrhoeal illness last week.

Her vital signs are HR 100/min, BP 100/80, RR 20/min, temp

39°C, BSL 4.0 mmol/L. She cannot follow your commands. She does not make eye

contact or respond to you. You find no meningism. You do not find any focus of infection on examination.

Question:

Which of the following is the most likely cause of her

delirium?

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