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Self-mutilation resulting in bacterial meningitis
S Chillag1, K L Chillag, V K Bhanot
1Department of Medicine, WVU Health Sciences Center, Charleston.
Abstract:
Self-mutilation and particularly self-destructive dermatoses are not usually life-threatening. This case involves a man who met the DSM-III R diagnostic criteria for delusional (paranoid) disorder, somatic type. His destructive behavior involving the face and scalp resulted in osteomyelitis and pneumococcal meningitis. He responded to treatment initially, but was later lost to follow-up. No similar case of self-mutilation has been reported.
Insights
This case report details a rare instance of self-mutilation leading to severe infections like osteomyelitis and meningitis in a patient with delusional disorder. Such destructive dermatoses are typically not life-threatening, making this case unique.
Area of Science:
- Psychiatry
- Dermatology
- Infectious Diseases
Background:
- Self-mutilation and self-destructive dermatoses are generally not life-threatening conditions.
- Delusional disorder, somatic type, is a psychiatric condition characterized by non-bizarre delusions about bodily functions or sensations.
Observation:
- A male patient meeting DSM-III-R criteria for delusional disorder, somatic type, exhibited destructive behavior targeting his face and scalp.
- This self-inflicted damage led to severe secondary complications.
Findings:
- The patient developed osteomyelitis (bone infection) and pneumococcal meningitis (a serious brain infection) as a direct result of his self-mutilating behavior.
- While initial treatment showed promise, the patient was subsequently lost to follow-up.
- This represents a unique and previously unreported case of self-mutilation with such severe sequelae.
Implications:
- Highlights the potential for severe medical complications arising from self-destructive dermatoses in psychiatric patients.
- Underscores the importance of comprehensive management for individuals with delusional disorder to prevent physical harm.
- Suggests a need for increased awareness and reporting of similar cases to better understand the spectrum of self-mutilation in psychiatric illness.