A 30-year old male with history of alcohol abuse for 15 years is brought to the hospital emergency with complaints of fearfulness, mis-recognition, talking to self, aggressive behavior, tremulousness and seeing snakes and reptiles that are not visible to others around him. There is history of drinking alcohol two * days prior to the onset of the present complaints. He is most likely suffering from:

Ans. is 'a' i.e. Delirium TremensRef Neeraj Ahuja 4th/e p36, 37It is a case of Delirium tremensIt is the most severe alcohol withdrawal syndromeIt usually occurs within 2-4 days of complete or significant abstinence.Symptoms areClouding of consciousnessPoor attention spanVisual hallucinations which are often vivid and frighteningTactile hallucinations and auditory hallucinationsMarked autonomic disturbancesTachycardia Fever Sweating Hypertension Pupillary dilatationPsychomotor agitation and ataxiaInsomniaDehydrationThe course is short with recovery occurring within 3-7 daysAlcoholic hallucinosisThis can be ruled out easily because it is characterized by the presence of auditory hallucinations and the other usual features of delirium tremens are absent.