History and admission findings: A 39-year-old woman was admitted for the treatment of recurrent septicemia, corrosive esophageal and gastric mucosal injury, and bloody stools.
Investigations: A search of her hospital room provided evidence of a self-inflicted disorder. Bacteremia with typical fecal flora had been caused by self-injected intravenous inoculation of stool and the esophageal ulcers by swallowed vinegar.
Treatment and course: The patient was initially treated with meropenem. After initial clinical and psychological stabilization the patient refused further psychiatric or psychosomatic treatment.
Conclusion: Fluctuating or bizarre symptoms and unusual diagnostic findings may indicate self-inflicted disorders, in which the symptoms of illness are caused by the afflicted person him/herself.
Georg Thieme Verlag KG Stuttgart, New York.