Factitious diabetes mellitus confirmed by ascorbic acid.
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We report a girl aged 31/2 years in whom signs and symptoms of diabetes mellitus were falsified by the mother. Evaluation in hospital rapidly ruled out diabetes mellitus and the use of ascorbic acid as a marker enabled us to prove urine substitution by the girl's mother. (+info)
Munchausen's syndrome or chronic factitious illness: a review and case presentation.
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The psychosomatic disorder termed Munchausen's syndrome has gained official recognition in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, in which it is referred to as a "chronic factitious disorder with physical symptoms." Sporadic case reports have been published over the years. Few patients with this disorder allow themselves to be psychologically evaluated or seek treatment for the disorder itself. We report here an unusual case in which a young woman sought help for her hospital-peregrinating behavior. (+info)
A nuclear medical manifestation of Munchausen's syndrome.
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A man with an enlarged and tender left calf, chest pain, intermittant hemoptysis, and shortness of breath was referred for a lung scan. Positioning for the ventilation part of the study revealed a high level of radioactivity in the lungs, kidneys, bladder, colon, and salivary glands. The patient denied previous hospital studies and suggested that he may have become contaminated while transporting radioactive materials as an independent truck driver. He was found to be a classic example of Munchausen's syndrome. (+info)
A case of Munchausen syndrome masquerading as unstable angina.
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The authors report the case of a man who presented with unstable angina and who, at different hospitals over a period of several months, underwent two heart catheterizations, intra-aortic ballon counterpulsation, and eventual bypass surgery despite essentially normal coronary arteries. (+info)
Munchausen syndrome by proxy.
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Information is presented about 19 children, under age 7 years, from 17 families, whose mothers consistently gave fraudulent clinical histories and fabricated signs so causing them needless harmful medical investigations, hospital admissions, and treatment over periods of time ranging from a few months to 4 years. Episodes of bleeding, neurological abnormality, rashes, fevers, and abnormal urine were commonly simulated. Often the mothers had had previous nursing training and some had a history of fabricating symptoms or signs relating to themselves. Two children died. Of the 17 survivors, 8 were taken into care and the other 9 remained at home after arrangements had been made for their supervision. Study of these children and their families has enabled a list of warning signs to be compiled together with recommendations for dealing with suspected acts. The causes and the relationship of this form of behaviour to other forms of non-accidental injury, iatrogenic injury, and parental-induced illness are discussed. (+info)
HIV malingering in the accident and emergency department.
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This paper reports a number of cases of patients attending an accident and emergency (A&E) department claiming to be HIV positive when they have been tested negative and are known to be negative by other departments in the hospital. The reasons for these patients claims are not always apparent. These patients may place an inappropriate workload on an already busy department. We caution doctors working in A&E departments to be vigilant when dealing with patients who claim to be HIV positive when there are no clinical or laboratory findings to substantiate the claim and we recommend liaison between relevant departments within a hospital and the patient's general practitioner (GP) when dealing with these patients. (+info)
Misdiagnosed HIV infection in pregnant women: implications for clinical care.
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Out of nearly 900 women in a research study of human immunodeficiency virus infection in pregnancy, 8 were subsequently found not to be infected. Misdiagnoses could have resulted from (a) laboratory errors or specimen mixups; (b) failure to follow the testing algorithm recommended by the Centers for Disease Control and Prevention to confirm results; (c) women perceiving they were infected by high-risk behavior in the absence of testing, despite the receipt of negative test results, or based on screening results only; or (d) factitious disorder, HIV Munchausen syndrome, or malingering. Because of the potentially devastating impact of an HIV diagnosis and the toxicity of HIV therapies, health care providers should obtain independent confirmation of the diagnosis before initiating treatment or followup for HIV based on patient report or provider referral. Quality test interpretation and counseling must be ensured. Therapeutic interventions may be indicated for persons intentionally and falsely presenting themselves as HIV-infected. (+info)
Feigned HIV infection/AIDS: malingering and Munchausen's syndrome.
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Feigned HIV infection or acquired immunodeficiency syndrome (AIDS), in which people mimic infection with or disease due to HIV, accounted for 1.7% of admissions to our specialist HIV unit in Central London over a 5 year period. Of 12 patients with feigned HIV/AIDS, 11 were HIV antibody-negative, and one refused testing. Presenting histories were sometimes grandiose, unusually tragic, or unlikely in relation to the patients' healthy appearance, and often included admissions to other specialist HIV units. Substance abuse was suspected in over half of the patients described, a higher frequency than that observed in our HIV-infected patient population. The possibility of feigned HIV/AIDS should be remembered in persons with self-reported HIV infection. Recognition of this condition is important to avoid costly and potentially dangerous investigation and therapy. (+info)