### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, My wife is undergoing treatment for Acute Myeloid Leukemia, as a consequence of successful chemo/radiotherapy for inflammatory breast cancer. Prior to the onset of the breast cancer, she had been treated for Hepatitis C (100% cure - zero detectable virus) with chronic fatigue syndrome as the result of the interferon/ribavirin therapy. Following the hep therapy, she was finally diagnosed with a low cortisol output, which explained the CFS. However, now in day 17 of the AML, she has tachycardia of 145 - 150, intermittent fevers of 101 - 102.5, and delirium. I suggested there might be a link between circulating cytokine levels, specifically IL-1, IL6 and TNF alpha, and the inability of the adrenal cortex to respond accordingly, but the oncologist basically called me an idiot and became angry that I was going off on a tangent. Can you advise if my theory merits consideration? thank you - Richard

### output:

Thanks for your question on Chat Doctor. I can understand your concern. Yes, you are right. High levels of cytokines in blood can cause tachycardia and fever. But delirium is unlikely in this context. Delirium in AML (acute myeloid leukemia) suggest possibility of brain involvement (malignant spread in brain). So better to first get done MRI brain with Contrast to rule out brain metastasis. Another possibility is electrolyte disturbance. So get done serum sodium and potassium level. Hope I have solved your query. Wishing good health to your wife. Thanks.