Münchausen Syndrome. A case report

Abstract

Munchausen's syndrome describes patients who build health histories with fake symptoms and nonsense evidences about diseases; they submit themselves to several clinic investigations, surgeries and unnecessary treatments that sometimes are dangerous for their lives. The syndrome is inspired on baron Karl Friedrich Hieronymus Von Münchausen (1720-1797) a German adventurer soldier, notorious for his nonsense, exaggerated and fancy stories about his war feats. In our institution it has been presented this situation frequently, which motivates us to reveal the reasons that make VIH seropositives to keep hospitalized during long periods of time, to come back to the centre and ask for medical services when they do not have alterations since the clinical point of view. This research goal is to characterize the clinic situation of Münchausen syndrome, to diagnose it and to establish the effective intervention strategy. It is presented a case report of a 39 year old man who has diagnosis elements of the syndrome: with variegated health history, several symptoms and diseases. The physical examination and complementaries cannot show the organic origen of all the symptoms. The clinical situation presents real and fictitious

elements, complex since the diagnosis and therapeutic point of view that come from Münchausen syndrome. As the intervention strategy it is suggested the adequate diagnosis (by exclusion) of the Münchausen syndrome. The treatment for real organic and tested problems and the combination of shock and support therapy and psychopharmacs finally to think carefully on the possibility to face a Münchausen´s Syndrome with a variegated and complex clinical history.