An 86-year-old Japanese man presented with altered mental status (AMS) for several weeks and recent dyspnea and anorexia. He had been unwell for several weeks for an unknown reason, when 10 days before the presentation, he developed dyspnea, anorexia, and general malaise. In the late morning of the presentation day, when the patient saw his primary doctor on schedule, the doctor found him lethargic and referred him for further evaluation and treatment. The patient lived home with his wife. Per the patient's family and homevisit care worker, the patient had a cognitive decline over the last several weeks, and he became to make frequent phone calls for help because he “does not know what to do.”.
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