A Curious Case of Encephalopathy in a Hospitalized Patient: Round Up the Unusual Suspects

This case describes a 52-year-old female who developed encephalopathy after being hospitalized with sepsis from a recently placed Permcath. A grade two decubitus ulcer was also a potential source of infection. Cefepime and Vancomycin were empirically begun, and the patient improved hemodynamically and clinically. She developed encephalopathy on day six of hospitalization. When the Cefepime was discontinued the encephalopathy promptly resolved. The causes of hospital acquired encephalopathy and potential difficulties in making this diagnosis are discussed with special emphasis on Cefepime induced encephalopathy.