A teenage boy misdiagnosed as schizophrenic has been found to be suffering from a “cat scratch” skin infection that triggered psychotic episodes.
The 14-year-old’s case Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome was recently published in the Journal of Central Nervous System Disease.
The boy, who lives in the US, underwent multiple evaluations for “sudden-onset” psychotic behaviour including hallucinations, delusions, suicidal and homicidal thoughts.
He was hospitalised four times over 18 months. It began after October 2015 when he began feeling “overwhelmed, confused, depressed and agitated”.
The boy was at this stage of his life was “achieving excellent course grades”, socially active and the lead actor in a school play. He also received an award in fencing.
But suddenly he couldn’t go to school, became dysfunctional and had “unpredictable rage outbursts”.
He said he was the ‘damned son of the devil’
He also believed he had special powers and that a family cat wanted to kill him.
“He said that he was an ‘evil, damned son of the devil’ and wanted to kill himself because he was afraid of his new-onset homicidal thoughts toward those he cared about,” the journal states.
“In October 2015, he was admitted for emergency psychiatric hospitalisation at a local hospital and was placed on aripiprazole for major depressive disorder (MDD) with psychotic features. He was discharged after one week, still somewhat psychotic but no longer suicidal or homicidal.”
By December 2015, he refused to leave the house and his mum had to quit her job to look after him full-time. A month later he had excessive fatigue, short breath and headaches daily.
His early medical history was said to be “unremarkable” except for an episode of depression brought on by bullying at school when he was nine years old.
An evaluating psychiatrist noted back then he might have Asperger’s. He was also treated for a respiratory infection in 2014.
Bug bites investigated
In June 2015, he visited a farm in Missouri and was treated with topical steroids for multiple bug bites.
“The family history was positive for depression and alcohol abuse on both sides of the family tree, possible bipolar disorder, compulsive gambling, and possible attention deficit hyperactivity disorder,” the journal states.
The family had two adopted cats who were strays. One of them had an open wound over his back.
They also had a dog, a spotted gecko and a giant African millipede. A visiting dog infested with fleas also entered the home in 2011.
The boy was exposed to cat bites and scratches. He was also frequently outdoors prior to his misdiagnosis and had exposure to mosquitoes and spiders.
In mid-2016 he was hospitalised for 11 weeks at a psychiatric teaching hospital and after testing was diagnosed with schizophrenia and obsessive-compulsive disorder.
But on returning home in August his parents noticed what looked like “stretch marks” and refused to re-hospitalise him.
Neurobartonellosis a likely prognosis
A doctor in January 2017 considered the teen might have neurobartonellosis – an altered mental status caused by bacterial infection. Lesions were found on his thighs and armpit.
It was also determined the bacteria Bartonella henselae had infected his bloodstream. The bacteria is also associated with cat-scratch disease.
He was eventually treated with antimicrobial chemotherapy to treat his bacterial infections and is said to be back participating in the activities he was involved in before his misdiagnosis. He is doing well academically and socially. The family had spent more that $560,000 on medical treatments.
In other recent medical news, a US student was the subject of a research paper after he died from eating leftover pasta.
A woman also nearly died recently after injecting herself with fruit juice via an intravenous blood drip.
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