The Baron revisited: a case report

The Munchausen patient seeks hospital care to satisfy a masochistic streak and is willing to undergo operations and painful hospital procedures while at the same time being abusive and aggressive. He often uses an argument with hospital personnel as an excuse to leave against medical advice. The diagnosis is rarely made in the emergency department but might be made more frequently if lists of known "Munchausens" were circulated through emergency department and if emergency physicians were more aware of the problem. The physician in doubt, however, will do better to risk being fooled and manage the patient as if his complaints were real. One such case is reported.