title: [Acute confusional syndrome due to acute nicotine withdrawal].
abstract: Delirium or acute confusional state among hospitalized patients is a frequent and serious problem. It is characterized by acute onset symptoms, fluctuating course, impaired attention, unorganized thinking, and altered level of consciousness. Delirium, as a manifestation of acute nicotine withdrawal syndrome has been reported in the reviewed literature only in eight cases. We report the case of a heavy smoker admitted because of a reagudization of his chronic obstructive pulmonary disease. At the third day of nicotine abstinence, he developed delirium with a rapid improvement of his symptoms after treatment with a transdermal nicotine patch. This description suggests that in hospitalized heavy smokers who develop delirium with agitation, a simple trial with a nicotine patch can offer a dramatic therapeutic response in a few hours, constituting additionally a confirmatory test. The recognition of delirium as a manifestation of nicotine withdrawal could allow to determine the origin of symptoms and to apply the appropriate therapy, in certain complex cases that now remain undiagnosed.
mesh_terms: D000208:Acute Disease; D000368:Aged; D003693:Delirium / Q000139:chemically induced* / Q000188:drug therapy; D006760:Hospitalization; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000628:therapy; D008297:Male; D009538:Nicotine / Q000009:adverse effects* / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D013577:Syndrome
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine
vernacular_title: Sindrome confusional agudo por abstinencia aguda de nicotina.