Generally a clinical diagnosis, however comorbidity is common so additional work-up/screening is required:
Labs:
Serum glucose
Serum ethanol
CBC
Metabolic panel
LFTs
CK
Drug screen if concern for coingestion
Imaging:
CXR in all patients (pneumonia is most common infection)
Consider head CT if evidence of head trauma, focal deficits, or other concerning findings
Consider LP if concern for meningitis
Serum glucose
Serum ethanol
CBC
Metabolic panel
LFTs
CK
Drug screen if concern for coingestion
CXR in all patients (pneumonia is most common infection)
Consider head CT if evidence of head trauma, focal deficits, or other concerning findings
Consider LP if concern for meningitis
Delirium tremens
Ethanol toxicity
Excited delirium
Alcohol use disorder
Acute psychosis
Alcohol withdrawal
Alcohol withdrawal seizures
Beer potomania syndrome