Delirium Upon Presentation to the Pediatric Emergency Department: A Case Series

Area of Science:

• Pediatric Emergency Medicine
• Infectious Diseases
• Neurology

Background:

• Delirium in children is challenging to diagnose in acute care settings.
• Influenza is a common pediatric illness, but its association with delirium is not well-established.
• Identifying non-infectious causes of delirium is standard practice.

Observation:

• Case series of children presenting to the emergency department (ED) with delirium.
• No clear inciting cause for delirium was identified, apart from influenza infection.
• Workups varied, including extensive neurologic evaluations in some cases.

Findings:

• Children with influenza may be at higher risk for developing delirium.
• Clinical presentation of delirium in pediatric patients can be subtle.
• Absence of fever or other common triggers does not rule out delirium.

Implications:

• Heightened awareness among ED and primary care physicians is crucial for earlier delirium recognition.
• Prompt diagnosis can prevent extensive and potentially unnecessary investigations.
• Recognizing influenza-associated delirium may reduce hospitalizations and improve patient outcomes.
• Further prospective studies are needed to confirm the prevalence of delirium in pediatric influenza cases.