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[Factitious disorder--fever and delayed wound healing]
K Fritzsche1, N Venhoff, A Larisch
1Abteilung für Psychosomatische Medizin und Psychotherapie am Universitätsklinikum Freiburg, Hauptstr. 8, 79104 Freiburg. kurt.fritzsche@uniklinik-freiburg.de
Deutsche Medizinische Wochenschrift (1946)
|May 1, 2008
Summary
A patient with unexplained fevers and poor wound healing was diagnosed with factitious disorder. She self-administered contaminated water, a coping mechanism for psychological trauma, leading to successful psychotherapy after empathetic care.
Area of Science:
- Psychiatry
- Rheumatology
- Infectious Disease
Background:
- A 23-year-old woman presented with recurrent febrile episodes and impaired wound healing over three years.
- She required continuous antibiotic treatment due to persistent, unexplained symptoms.
Observation:
- Extensive diagnostic tests yielded no definitive findings, raising suspicion of a self-inflicted cause.
- Psychological evaluation revealed the patient admitted to self-manipulation via intravenous injection of contaminated water.
Findings:
- The self-inflicted injuries were interpreted as a response to psychological trauma and an attempt at self-preservation.
- The patient's admission facilitated trust and engagement in psychotherapy.
Implications:
- Empathetic, non-confrontational approaches are crucial when suspecting factitious disorder.
- Respecting the patient's self-harm as a coping mechanism can facilitate acceptance of psychotherapy and prevent loss of face.
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