Despite its high prevalence and serious consequences, delirium is under-recognized and poorly managed. The main reason is diagnostic tunnel vision, especially the tendency to treat it exclusively as secondary to infection, leading to complex septic workups. However, infection is not always present, and delirium is multifactorial in nature, including recent medication changes, environmental disturbances, lack of sleep, or poorly managed pain. Polypharmacy and psychoactive drugs are major contributors, along with environmental factors such as sensory deprivation, noise and ward transfers. Sleep disturbance is associated with an increased risk of delirium and pain acts independently. By stopping the medication and stabilizing the routine, cognition can improve within a few days without antibiotics. It is necessary to overcome single-cause thinking.[1][2][3][5][7]