Acute respiratory failure leading to emergency intubation: an unusual manifestation of Munchausen's syndrome.
Munchausen's syndrome is a contrived psychiatric disorder, in which patients present with an intentionally produced or feigned illness with the aim to assume the sick role and to gain medical attention. Patients may even seek the application of invasive procedures, sometimes with serious risk to life. We describe the case of a 38-year-old woman, who repeatedly presented with apparent respiratory failure leading to tracheal intubation and mechanical ventilation. In addition, we present a systematic review of the literature over respiratory and pulmonary manifestations of Munchausen's syndrome. This case report may contribute to the awareness among emergency physicians of Munchausen's syndrome as a differential diagnosis of respiratory failure. Recognition of this psychiatric disease is not only important for correct medical diagnosis and treatment, but also essential in protecting the patients from unnecessary invasive and aggressive medical procedures.
Klaassen
F Antonique J
FA
Department of Anaesthesiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Schober
Patrick
P
Schwarte
Lothar A
LA
Boer
Christa
C
Loer
Stephan A
SA
D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D009110:Munchausen Syndrome / Q000150:complications / Q000175:diagnosis*; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy*