Munchausen syndrome as scorpion biting: a misdiagnosis

Reza Bidaki,Mehrdad Roozbeh,Mohamad Amin Sharifi,Mohammad Ali Abdolkarimi Davarani,Seyed Nader Mostafavi

doi:10.15171/jept.2016.15

Abstract

Factitious disorder as Munchausen syndrome is a time and money consuming condition that is presented with different signs and symptoms. In emergent situations, it is not a differential diagnosis with high priority, but when it becomes recurrent with atypical symptoms, factitious disorder and malingering should be considered as well. In this survey, we report an odd and interesting presentation of a factitious disease as a scorpion sting which misled some professional healthcare providers until the patient finally confessed that she used turmeric to mimic the signs of a scorpion sting. She exaggerated her symptoms when asked about the details of the mechanism of the scorpion bite. When encountering an emergent condition, after ruling out the critical conditions especially when the symptom is recurrent, factitious disorders should be considered. Consultation with a psychiatrist help the team manage the patient properly.

Highlights

Factitious disorders, including Munchausen syndrome, are one of the most prevalent cases health care providers might encounter anytime (1)
A 49-year-old married woman complaining of scorpion stings was referred to the emergency toxicity center
The psychiatric consultation was requested but she left the hospital before the psychiatrist could visit her

Summary

Introduction

Factitious disorders, including Munchausen syndrome, are one of the most prevalent cases health care providers might encounter anytime (1). A 49-year-old married woman complaining of scorpion stings was referred to the emergency toxicity center. After being under close monitoring, she became stable and was discharged from the hospital 2 days later Year she referred to the emergency room, complaining about scorpion stings in her right thigh and both lower extremities. The psychiatric consultation was requested but she left the hospital before the psychiatrist could visit her One month later, she referred to the hospital complaining about shortness of breath and scorpion sting at the posterior region of the left leg. The psychiatric consultation was requested, she did not have any history of suicide, but she had severe anxiety and mild depression She was raised in a chaotic family that exaggerated her symptoms and when asked about the details of the mechanism of the scorpion bite, she confabulated. When her motivations were revealed she did not come back to the hospital again

Discussion

Conclusion