A person was addicted to alcohol for some 10 years. He got injured on his toe and wound was not healing. He was admitted to the hospital where he was on bed trying to catch some bugs on bed and described doctor as his brother. He also complains uncontrollable fear of being murdered, insomnia etc. Likely Diagnosis is: March 2013 (b)

**Core Concept**
Delirium tremens (DTs) is a severe form of alcohol withdrawal characterized by altered mental status, hallucinations, and autonomic instability. It occurs typically 48-72 hours after the last drink in individuals with a history of prolonged and heavy alcohol use.

**Why the Correct Answer is Right**
The patient's symptoms, including hallucinations, insomnia, and altered mental status, are consistent with delirium tremens. This condition is often precipitated by a physical stressor, such as an injury, which can lead to autonomic instability and exacerbate the withdrawal symptoms. The patient's history of prolonged alcohol use increases his risk of developing DTs.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the patient's symptoms or history. While it may be a consideration in a patient with a traumatic injury, it does not explain the patient's altered mental status or hallucinations.
**Option B:** This option is incorrect because it does not accurately describe the patient's symptoms. While the patient may have some cognitive impairment, the primary concern is his altered mental status and hallucinations, not a primary psychiatric diagnosis.
**Option C:** This option is not directly related to the patient's symptoms or history. While it may be a consideration in a patient with a traumatic injury, it does not explain the patient's altered mental status or hallucinations.

**Clinical Pearl / High-Yield Fact**
Delirium tremens is a medical emergency that requires immediate attention. Treatment typically involves benzodiazepines to manage withdrawal symptoms and prevent seizures.

**Correct Answer:** B. Delirium tremens

✓ Correct Answer: C. Delirium tremens