title: [An auto-iatrogenic disease].
abstract: A 55-year-old practitioner from an island in the northern sea felt an increasing hypersensitivity of his entire body to various ambient and nutritional allergens and toxics. He started to treat himself with increasing doses of glucocorticoids and moved to a southern climate in Lanzarote and later on to the Swiss mountains in the grisons. On admission to our hospital in December he was in a disastrous psychotic condition, trying to cool down his body by laying naked on his bed at ambient temperatures around the freezing point. He had consumed on average 250 mg prednisone daily over weeks. As we found out later his personal assistant travelling with him was giving him glucocorticoids through the infusion during his hospital stay. He developed a necrotizing septic phlebitis at the infusion site followed by a Pseudomonas aeruginosa sepsis with fatal multiorgan failure. This case illustrates the dangers of self-treatment by doctors and the difficulties in treating a physician.
authors.affiliation: Medizinische Klinik, Kantonsspital, Chur. walter.reinhart@scag.gr.ch
authors.forename: W H
authors.initials: WH
authors.lastname: Reinhart
mesh_terms: D000893:Anti-Inflammatory Agents / Q000633:toxicity; D001284:Atrophy; D003428:Cross Infection / Q000139:chemically induced / Q000175:diagnosis; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000633:toxicity; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000633:toxicity; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000188:drug therapy*; D010815:Physician Impairment / Q000331:legislation & jurisprudence; D011241:Prednisone / Q000633:toxicity; D011552:Pseudomonas Infections / Q000139:chemically induced / Q000175:diagnosis; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000209:etiology; D012651:Self Medication / Q000009:adverse effects*; D012772:Shock, Septic / Q000139:chemically induced / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000175:diagnosis*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D008776:Methylprednisolone Hemisuccinate; D011241:Prednisone