Factitious Disorder: An Angioedema Copycat.

Factitious disorder (FD) is a psychiatric illness in which an individual assumes the role of a patient by manifesting physical or psychological symptoms without conscious or obvious reward. Here, we present the case of a 28-year-old female with a history of endotracheal intubations 19 times secondary to anaphylaxis. During the current hospital visit, she complained of cough, shortness of breath (SOB), arthralgia, wheezing, and rashes over the chest. Serum C1 esterase inhibitor and C4 levels have been negative on multiple occasions. A previous laryngoscopy showed a normal larynx, normal vocal cords, and no obstruction. Due to the patient's history of multiple invasive procedures, malingering was considered a possible differential diagnosis. The patient also has a past psychiatric history of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), adjustment disorder with anxious mood, and anxiety disorder. Her complicated psychiatric history coupled with her multiple endotracheal intubations associated with normal laboratory findings raise the suspicion of factitious disorder. This case is meant to demonstrate the complicated matter of helping a patient whose psychiatric illnesses have put her at risk of serious health complications for the sake of assuming a sick role.

Multiple Massive Bullae Formation Within Lung of SARS-CoV-2-Infected Patient.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has altered the world for more than two years and continues to impact the globe in numerous ways. This disease has a wide spectrum of presentations that can range from no symptoms at all to rapid decline and death. Complications of SARS-CoV-2 include acute respiratory failure, pneumonia, acute respiratory distress syndrome (ARDS), acute liver injury, acute cardiac injury, septic shock, blood clots, multisystem inflammatory syndrome in children, and chronic fatigue. Although many complications such as these and others exist, we are still seeing novel developments related to the virus. In this case report, we present a patient with SARS-CoV-2 who concurrently had a massive left lung bulla of unknown etiology. Due to the size and scale of this bulla, we suspect it to be a complication of his SARS-CoV-2 infection. A few cases have been described in the literature beforeand here we would like to contribute another one. Our goal is to help expand the body of evidence demonstrating the far-reaching and atypical nature that SARS-CoV-2 can present with today.