Occult abdominal infection and psychiatric symptoms: A case report

Abstract

Introduction The clinical presentation of numerous infectious processes can include diverse Subtle cognitive dysfunction or mood change (e.g., irritability), depression, psychosis and delirium are the most likely symptoms to occur and may result from a small focus of chronic infection. Aims Disclose an unusual clinical case with symptoms as the first presentation of an infection. Methods The review was based on scientific documentation published in PubMed database, journals and reference textbooks. We used the following terms as keywords occult infection and psychiatric symptoms. Results We present the case of a 48-year-old woman without history until January 2015, time when she had insidiously developed personality changes with emotional instability. Five months latter, during her stay in urgency department after her second suicide attempt, her dysphoric mood, defiant behaviour and persistent suicidal ideation were interpreted as a personality disorder that has led to a compulsory admission. Forty-eight hours after the admission, she became febrile with fluctuation of consciousness and ended up being transferred with sepsis to an intensive care unit. The carried out investigation has shown an abdominal infection, i.e. peritoneal abscesses without isolated infectious agent. With the resolution of the infectious process, the symptoms subsided and she returned to her premorbid personality level. Conclusions Infectious diseases can firstly present with Timely investigation of the underlying etiology for symptoms that persist after conventional treatments is crucial for appropriate intervention and full recovery of the patient.