The role of ciprofloxacin in a patient with delirium due to multiple etiologies.

A 40-year-old female with a lumbar drain was admitted to the neurosurgery service with a bacterial meningitis. During the course of her treatment with multiple central nervous system (CNS) active medications, the patient became disoriented and agitated with visual hallucinations and generalized myoclonus. A psychiatric consultation was requested. The case is presented and discussed within the context of the importance of understanding etiological mechanisms in treating and reversing delirium. The fluoroquinolone agent ciprofloxacin was considered to be the primary etiology of the patient's delirium. This class of medication as a cause of altered mental status is discussed.