RESUMEN
In this study, we present a case of new-onset illness anxiety disorder (IAD) in a 21-year-old female patient after Heliobacter pylori infection. The patient experienced a distressing preoccupation with having or acquiring a serious illness with mild somatic symptoms for more than six months. IAD adversely affected our patient's life and made her engage in excessive care-seeking behaviors and maladaptive avoidance in some instances. In this case, we highlight the unique presentation of symptoms related to illness anxiety disorder and H. pylori infection. Furthermore, we discuss the possible psychosocial factors that are considered risk factors for developing IAD. We also discuss the pharmacological and psychological treatment options for patients with such a presentation.
RESUMEN
Oculogyric crisis (OGC) is a rare type of acute dystonia characterized by spasmodic upward deviation of the eyes lasting for a few minutes to several hours. It is commonly seen with the administration of first-generation antipsychotics and rarely reported in patients taking second-generation antipsychotics. Although aripiprazole, a second-generation antipsychotic, is known for its low potential for extrapyramidal side effects (EPS), there are multiple case reports of it resulting in acute dystonia, especially OGC. In this paper, we report a case of aripiprazole-induced OGC in a 16-year-old female patient after a suicide attempt by taking 40 mg of aripiprazole and 5 g of acetaminophen. The necessary investigations were ordered, and the patient's dystonic symptoms resolved completely after administering parenteral diazepam and benztropine.
RESUMEN
Psychogenic polydipsia is a rare condition characterized by overconsumption of water. It can lead to water intoxication, which is potentially a life-threatening situation. Moreover, it usually occurs in patients with mental disorders, mainly schizophrenia. This report discusses a successful treatment of a 16-year-old male with psychogenic polydipsia and delusional disorder presenting to the emergency room with a hyponatremia-induced seizure. After stabilizing the patient, he was referred to a psychologist, and behavioral therapy was conducted. Post-discharge follow-ups revealed that behavioral therapy and the use of self-monitoring technique were effective in controlling the patient's condition. His water intake was reduced from 15 liters per day to three liters per day. This case highlights the importance of psychological assessment for patients with features suggestive of psychogenic polydipsia. It also highlights the need for immediate admission and prompt treatment for such patients as it is a high-risk condition.
RESUMEN
A 30-year-old Pakistani construction worker, not known to have any chronic medical illnesses, presented to the emergency room with a history of ingesting two cups of cement diluted in water, seven hours prior to the presentation, in addition to a cut on his left wrist using a sharp piece of ceramic. He was conscious, oriented, and vitally stable. Physical examination was unremarkable except for epigastric hardness and tenderness. Treatment upon admission included escitalopram 10 mg and haloperidol 5 mg. Upper GI endoscopy showed large, hard cement in the stomach and multiple pre-antral erosions. The patient was started on omeprazole 40 mg after the procedure. Exploratory laparotomy and gastrotomy were performed as well. The procedure showed a foreign body, gypsum, occupying the stomach and extending from the fundus to the pylorus. Multiple small foreign bodies were seen in the rectum. The foreign bodies were extracted completely. Before discharge, a suicide risk assessment was done using the modified SAD PERSONS scale. The patient's total score was 5, which is low risk. The patient received psychiatric care, and his post-discharge follow-up was unremarkable.