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Factitious hemoptysis. Adding to the differential diagnosis
J B Baktari1, D P Tashkin, G W Small
1Department of Medicine, UCLA School of Medicine.
Chest
|March 1, 1994
Summary
Factitious hemoptysis, where patients fake coughing up blood, can be challenging to diagnose. A thorough medical evaluation is crucial for identifying such cases, especially with unusual patient behavior.
Area of Science:
- Medical Case Reports
- Pulmonology
- Psychiatry
Background:
- Presents a case of factitious hemoptysis in a 36-year-old male.
- Highlights the diagnostic challenges associated with unexplained hemoptysis.
Observation:
- Patient presented with hemoptysis and chest pain, leading to extensive investigations.
- Multiple invasive procedures, including bronchoscopies and cardiac catheterizations, yielded negative results.
- Patient had a history of 23 prior hospital admissions for similar fabricated complaints.
Findings:
- Review of 11 similar cases shows patients are typically young (mean age 32) and sometimes healthcare workers.
- Methods of simulation, when identified, often involve self-inflicted wounds.
- The specific simulation method in the presented case remained undetermined.
Implications:
- Factitious hemoptysis should be considered in the differential diagnosis of unexplained hemoptysis.
- Unusual patient history and behavior are key indicators for considering factitious etiology.
- Highlights the importance of comprehensive patient evaluation to avoid unnecessary invasive procedures.