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An older man was admitted to the hospital for planned bowel resection. He reported drinking 8 to 10 ounces of whiskey daily for many years. During previous hospitalizations, he had no documented alcohol withdrawal symptoms or seizures. His last drink was 3 days prior to admission.
Over the first week postoperatively, he had no symptoms of alcohol withdrawal. On postadmission day 6 he developed an anastomotic leak, requiring urgent reoperation and antibiotics. On postadmission day 9, he became acutely disoriented and inattentive, with new abdominal tenderness. Imaging showed large intra-abdominal abscesses, and percutaneous drains were placed. His heart rate and blood pressure remained normal.
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Corresponding Author: Thomas D. Brothers, MD, 483 Bethune Building, 1276 South Park St. Halifax, Nova Scotia B3H 1K5, Canada (email@example.com).
Published Online: April 27, 2020. doi:10.1001/jamainternmed.2020.1091
Conflict of Interest Disclosures: Dr Brothers is supported in part by the Ross Stewart Smith Memorial Fellowship in Medical Research from Dalhousie University Faculty of Medicine. Dr Bach reported grants from the Michael Smith Foundation for Health Research outside the submitted work. No other disclosures were reported.
Acknowledgments: We thank the patient for granting permission to publish this information.
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