Patients’ right to confidentiality and sharing information with colleagues: The dilemma in managing a patient with Munchausen syndrome – A case report

We report the case of a young woman with a “pyrexia of unknown origin” in the background of a history involving SLE, ocular toxoplasmosis and Ig A nephropathy. The history was narrated by her with precise details but there was no documentary proof of any previous admissions. She had a prolonged hospital stay and repeated hospital admissions for the same illness with extensive investigations including a PET scan. Once evidence for “factitious fever” was overwhelming she got herself discharged from hospital refusing psychiatric help. Close scrutiny revealed that she had got herself admitted to several hospitals in the Western Province subsequently, with the same complaint, with all clinicians investigating her extensively, sometimes including invasive procedures. The ethical dilemma faced by us relating to sharing her clinical details with a wider clinical group is discussed.