Case Of Munchausen Syndrome Research Articles

"A-13-Year-Old Bangladeshi Girl Presented with Haematochezia: A Case of Munchausen Syndrome"

"A-13-Year-Old Bangladeshi Girl Presented with Haematochezia: A Case of Munchausen Syndrome"

When years of many different diagnosis may turn into one – a case of munchausen syndrome

IntroductionThe term Munchausen syndrome was first used in 1951 after Baron von Münchhausen, a German nobleman known for his exaggerated storytelling. DSM-5 refers to it as factitious disorder imposed on self: “falsification of physical or psychological signs or symptoms, or induction of injury or disease, (…) in the absence of obvious external rewards”.ObjectivesTo report a case of Munchausen syndrome and highlight the impact on its physical and psychiatric approaches.MethodsDescription of a clinical case based on medical records and a brief review on Munchausen syndrome.ResultsA 57-year-old female, with no previous psychiatric history, was evaluated by Psychiatry for complaints of depression with suicidal ideation. She reported family conflicts and a list of medical conditions and surgical interventions. According to the patient she was waiting for a cardiac transplant and said she had type 1 diabetes, myasthenia gravis, hepatic steatoses, dyslipidemia, hyperuricemia, mitral valve prolapse and was submitted to a thymectomy and cervical herniated disc surgery. She was on many different prescription pills. Even though she had blocked the access to her clinical records in other institutions, at our hospital she had multiple admissions to the emergency room, numerous follow-up appointments of different specialties and several allergies documented. She displayed many incoherencies throughout the interview, had a circumstantial speech and exuberant appearance.ConclusionsMunchausen syndrome remains a challenging diagnosis to physicians. This condition is not only associated with significant morbidity and mortality, but also with unnecessary tests and procedures, iatrogenesis, prolonged hospitalizations and increased health costs.DisclosureNo significant relationships.

Recurrent ear bleed with profound bilateral sensorineural hearing loss: A case of Munchausen syndrome

Factitious disorders and Munchausen syndromes present with history and physical symptoms to all specialties, and they are often extensively evaluated. Diagnosis of Munchausen syndrome is a challenge and patients often do not receive the correct diagnosis and appropriate care especially in settings where access to mental health professionals is difficult. We present a case of recurrent bleed from the right ear, bilateral profound hearing loss and jerky movement of limbs that was extensively evaluated and followed up for 4 years until a diagnosis of Munchausen syndrome was reached. This case reports the risk of harm to the patient and wastage of healthcare resources unless physicians begin to actively evaluate for factitious disorders.

A rare case of munchausen syndrome admitted with hemoptysis

A rare case of munchausen syndrome admitted with hemoptysis

A Case of Munchausen Syndrome by Proxy: Is it a Misdiagnosis?

Introduction : Child abuse is an area in Forensic Medicine where the diagnosis and management could be difficult. A deep history and close inward observation is a must where there is the slightest doubt of child abuse, in order to identify compounding factors and address accordingly. Here we report a case of repeated episodes of hematuria which was extensively investigated in three tertiary care hospitals revealing no cause, ultimately the mother being discovered as the culprit. Case report : A three year old boy who was extensively investigated for repeated episodes of gross hematuria since the age of seven months was admitted to Teaching Hospital, Peradeniya with another episode of gross hematuria. The child was clinically normal and investigations including blood, imaging studies and renal biopsy were unremarkable. Urine checked for bar bodies was positive. A case conference was held and it was decided to keep the child under parental custody under supervision of medico-legal authorities, while the mother is followed up at the psychiatry clinic for depression. Discussion : Munchausen syndrome (MS) by proxy is a psychiatric disorder which consists of fabricating or inducing illness in a child, usually by his mother, leading to unnecessary and potentially harmful medical investigations and/or treatment which are seen in this case as well. Thus this emphasizes the importance of thinking of MS, before going into potentially harmful investigations when the basic investigations are normal and identifying the importance of having an interlinked e database system in medical facilities in countries like Sri Lanka. Sri Lanka Journal of Forensic Medicine, Science & Law-December 2014-Vol.5 No.2; 3-7

Munchausen Syndrome as Dermatitis Simulata

Psychiatric comorbidity is associated with many dermatological disorders. It may be the cause for skin problem or may be the effect of a skin problem as skin being a visual organ. A 28-year-old female presented with multiple red lesions on the skin with unusual morphology and was diagnosed as dermatitis simulata. She gave history of multiple episodes of similar illnesses with admissions in various hospitals and being evaluated and dropping off in between treatments. After detailed psychological evaluation, patient was diagnosed as case of Munchausen syndrome.

An unusual case of Munchausen syndrome by proxy

An unusual case of Munchausen syndrome by proxy

Thoracic Outlet Syndrome in Adolescents Is Real

Thoracic Outlet Syndrome in Adolescents Is Real C hang and colleagues 1 from The Johns Hopkins Medical Institutions have provided us with a very helpful review of TOS occurring in adolescent patients. While a limited number of similar studies have previously been published, this is by far the largest series and large enough, I think, to provide meaningful data. Thoracic outlet syndrome is a “fuzzy” diagnosis; it is a real entity but one that is difficult to diagnose and that overlaps with multiple other problems. In adults, results are sometimes poor and the waters muddy. To a large extent, this is because adults often have numerous other factors in play, including liability and secondary gain issues, substance dependency and/or abuse, chronic regional pain syndrome, and underlying psychological disorders. The beauty of treating adolescents is that these factors are almost never in play; apart from the occasional case of Munchausen syndrome by proxy, adolescents with complaints of TOS have clear, unequivocal problems. Chang et al make 2 major points. First, adolescents present much more often with vascular (venous or arterial) TOS. This is most likely because they are more often athletes (venous TOS) and because congenital problems more frequently present early in life rather than in adulthood (arterial TOS). In turn, both entities are easier to treat and have better success rates than does neurogenic TOS. Second, all these patients have very good outcomes. I suspect that this is a result not only of the high percentage of vascular TOS but also of the factor cited in the previous paragraph—that these patients tend to have “clean” problems, without much of the baggage we are all used to dealing with in adults with TOS. Our experience in Rochester parallels this exactly: I am very happy to see a young patient walk through the door of our TOS clinic. The Hopkins experience provides a wealth of useful information. Most important, it lets us know that adolescents with TOS have excellent outcomes. Never make the mistake of denying a life-changing intervention to this group of patients just because of their age!

Otolaryngology fantastica: The ear, nose, and throat manifestations of munchausen's syndrome

Munchausen's syndrome (MS) is a form of severe, chronic, factitious disorder with physical symptoms. Some essential features define MS, such as recurrent, feigned, or simulated illness; peregrination (traveling or wandering); pseudologia fantastica; and drug abuse. Munchausen's syndrome by proxy (MSBP) classically involves a parent or other caregiver who inflicts injury or induces illness in a child. The aim of the present study was to summarize and study the main ear, nose, and throat (ENT) manifestations of MS and MSBP. A systematic literature review carried out in a tertiary university referral center. An appropriate string was run on PubMed to retrieve articles dealing with ENT manifestations of MS and MSBP. A double cross-check was performed on citations and full-text articles found using selected inclusion and exclusion criteria. In total, 24 articles were finally included in the study, describing 30 cases of MS or MSBP involving the ENT region; 15/30 (50%) cases involved the face, most often presenting as facial pain or facial swelling; and 7/30 (23.3%) cases presented with symptoms involving the ear. Six cases out of 30 (20%) were MSBP. MS and MSBP may present with symptoms involving the head and neck area, particularly the face and external ear canal. The ENT specialist should suspect MS in patients with strange and long-lasting symptoms, so as to avoid misdiagnosis and unnecessary treatments that waste time and money in the healthcare sector.

A case of Munchausen syndrome by proxy

As a retired German cavalry officer, Karl Friedrich Hieronymous Freiherr von (Baron) Munchausen (172097) acquired a reputation as a raconteur of preposterous stories about his adventures as a soldier, hunter, and sportsman 1 . Asher in 1951 first reported patients who consistently produced false stories and fabricated medical evidence which led to needless medical investigations, operations and treatments 2 . Roy Meadow in 1977 described a condition, Munchausen syndrome by proxy, where the mother, a relative or a caregiver fabricated illnesses in children 3 . Since then, many reports of this condition have been published in the medical literature from allover the world.

A Case of Munchausen Syndrome by Proxy With Subsequent Stalking Behavior

A case of Munchausen syndrome by proxy (factitious disorder by proxy) wherein the patient presented with symptoms of severe borderline personality disorder and questionable psychotic symptoms is discussed. This patient was also adjudicated for harassing and stalking a child protective services worker assigned to her case. Issues pertaining to possible feigning of psychotic symptoms were addressed in her inpatient treatment. Despite doubts concerning the veracity of some of her psychotic symptoms, the patient responded well to clozapine, and she was subsequently able to stay out of the psychiatric hospital for longer periods and make a reasonably good adjustment to living in a group home. After refusing to continue with clozapine therapy because of weight gain concerns, her adjustment declined.

Münchhausen-Syndrom und chronische Otitis media

In this case report an artificial disorder with symptoms of chronic otitis media and progressive hearing loss is described. This represents a rare case of Munchausen syndrome. The difficulties in diagnosis and therapy are shown by the development of the disease, produced by self damaging activities.

A case of Munchausen syndrome by proxy with subsequent suicide of the mother

Munchausen syndrome by proxy is a subtle and difficult to diagnose form of child abuse in which the carer (usually the mother) simulates, manipulates or produces symptoms of illness in the victim. In most cases the detrimental effect is caused by applying foreign substances or by airway obstruction. In the presented case a 20-month-old girl developed a spreading soft-tissue infection resistant to treatment on the left upper arm after vaccination, which required a number of surgical interventions. Repeatedly, microorganisms from the intestinal flora were isolated from the wound secretion. After the girl suffered respiratory and circulatory arrest, which required resuscitation measures, chemical toxicological tests revealed not medically prescribed benzodiazepines in serum and urine. When the mother, a trained nurse, was confronted with the allegation to have manipulated the symptoms of the illness she committed suicide. The forensic autopsy of the suicide produced numerous hints suggesting chronic self-damaging behaviour described as Munchausen syndrome. This case shows a number of manipulation forms with the maintenance of a chronic skin and soft tissue infection belonging to the rarer forms of inflicting damage to the child. It also illustrates that confrontation with the allegation of Munchausen syndrome by proxy creates a very stressful emotional situation that may lead to a suicidal act.

Failure of radioiodine treatment in Graves’ disease intentionally caused by a patient: Suspected Munchausen syndrome

We experienced a case with Graves' disease in which radioiodine treatment failed probably because of intentional spitting out of capsules of radioactive iodide. Chemical analysis of the substances collected from the trash in the treatment room demonstrated that its profile was the same as that of the capsules for radioiodine administration. Measurement of the iodine concentrations in a blood sample obtained at 24 h after the administration of radioiodine indicated that the patient showed iodine excess. These findings suggest that this may be a case of Munchausen syndrome.

Munchausen syndrome by proxy in the pediatric intensive care unit: An unusual mechanism.

OBJECTIVE: To present a case of Munchausen syndrome by proxy (MSbP) by a previously unreported mechanism, discussing the occurrence of MSbP in patients in the pediatric intensive care unit (PICU) and the use of covert video surveillance in the diagnosis of MSbP. DESIGN: Report of one case of a child who was proven to be the victim of MSbP while hospitalized in a PICU. SETTING: A six-bed PICU in a military teaching hospital. PATIENTS: One patient hospitalized for evaluation of confusing symptoms, later shown to be the victim of MSbP while on mechanical ventilation in the PICU. The mechanism of MSbP was intentional tracheal extubation by the patient's mother. INTERVENTIONS: Covert video surveillance. MEASUREMENTS AND MAIN RESULTS: After initiation of covert video surveillance in the PICU, the diagnosis of MSbP was confirmed. The patient recovered with some physical sequelae. CONCLUSIONS: Children can be victims of MSbP even in a closely monitored PICU. Covert video surveillance was crucial to confirming the diagnosis.

Bleeding ears: a case of Munchausen syndrome by proxy

A case is presented of a child who initially presented with genuine aural symptoms and pathology. Over a period of time it became apparent that the persistent aural bleeding, which is an uncommon feature of Chronic Suppurative Otitis Media, was the result of trauma inflicted by its mother; a case of Munchausen syndrome by proxy (MSBP).

Voluntary false confessions in a Munchausen patient: a new variant of the syndrome?

AbstractA case of Munchausen syndrome associated with habitual voluntary false confessions is described. It is suggested that voluntary false confessions may be an overlooked feature ofMunchausen syndrome. Furthermore, it is suggested that this case raises the possibility that a yet unidentified variant of Munchausen syndrome may exist which substitutes prison for hospital.

A case of Munchausen syndrome with frequent anal bleeding and severe iron deficiency anemia

A case of Munchausen syndrome with frequent anal bleeding and severe iron deficiency anemia

Another case of Munchausen syndrome by proxy?

Summary • Munchausen syndrome by proxy is a difficult to diagnose, complex form of child abuse. The subtleties of this type of abuse allow the parent to victimize the child by presenting a fictitious medical history, which then initiates a series of unnecessary diagnostic procedures and therapeutic interventions. By recognizing the warning signals of this syndrome health-care professionals can intervene, and prevent its potentially fatal results.

Munchausen Syndrome by Proxy Documented by Discrepant Blood Typing

The authors describe a case of Munchausen syndrome by proxy, a form of child abuse, documented by use of routine blood bank serologic procedures. While immunohematologic testing has been used in the legal arena to resolve issues of disputed paternity and to investigate instances of criminal acts, the authors believe this to be the first documented application to this clinical disorder.