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Factitious disorder presenting as bacteremia. Case report and literature review
G Catalano1, L C Toner, V A Alberts
1Department of Psychiatry and Behavioral Medicine University of South Florida College of Medicine, Tampa, USA.
Abstract:
A factitious disorder is typically a chronic illness that can be frustrating for the clinical team because it often eludes early diagnosis. Case reports in the literature show that patients can simulate almost any illness or disease state with some resorting to injecting themselves with contaminated substances to produce infection. A case is reported of a patient with self-induced bacteremia who presented with multiple episodes of polymicrobial bloodstream infections. The various types of factitious disorders and a review of treatment options are discussed. The current criteria for factitious disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) 4th edition are reviewed.
Insights
Factitious disorder, a chronic condition, presents diagnostic challenges as patients may simulate infections by self-injecting contaminated substances, leading to recurrent bacteremia. This case highlights the complexities in diagnosing and managing factitious disorders.
Area of Science:
- Psychiatry
- Infectious Diseases
Background:
- Factitious disorders are chronic conditions often eluding early diagnosis.
- Patients may simulate diverse illnesses, including infections, by self-inducing harm.
Observation:
- A case of self-induced bacteremia with recurrent polymicrobial bloodstream infections is presented.
- The patient simulated a severe infectious disease through self-injection of contaminated substances.
Findings:
- The case illustrates the potential for factitious disorder to manifest as complex, recurrent infections.
- Simulation of illness can lead to significant morbidity and diagnostic delays.
Implications:
- Highlights the importance of considering factitious disorder in unexplained recurrent infections.
- Emphasizes the need for a multidisciplinary approach to diagnosis and management.
- Underscores challenges in differentiating factitious infections from genuine infectious diseases.