Beware of self-declared AIDS victims who are suffering from another disorder - Munchausen's syndrome.
State epidemiologist Craig R. Nichols said many of them have traits similiar to those of the late Baron Karl Friedrich Hieronymus von Munchausen, who had a penchant for telling innocent after-dinner tall tales in his homeland of Germany during the 18th century.His imitators also have become tellers of tall tales.
More bluntly put, they are getting lots of press coverage and attention in large public arenas by fabricating an AIDS-related illness.
"This, however, is not to be interpreted that all patients who provide interviews to the media do not have the disease," Nichols said. "In fact, many of those patients provide a great public service by being willing to discuss their disease, especially as many of the people in Utah have not yet had any personal experience - have no friends or family members who have been infected by the virus."
But the specialist said he's aware of people who have claimed to have AIDS, and have been quoted in the media, when those individuals have, in fact, not been diagnosed as having the disease.
As epidemiologist for the Utah Department of Health, Nichols reviews the rec-ords of all AIDS cases in Utah. However, because of the state's confidentiality laws and his unyielding personal concern for the privacy of the patients, he cannot and does not inform the press when they have been misled.
But he says it happens frequently.
In fact, Munchausen's syndrome is so common that two former University of Utah physicians wrote a paper on a real case of a man who falsely said he had acquired immunodeficiency syndrome. It was printed in "Sexually Transmitted Diseases," January-March 1987.
Drs. Edward N. Robinson Jr. and Robert H. Latham, of the U. Center for Infectious Diseases, Diagnostic Microbiology, and Immunology, and the Division of Infectious Diseases, relayed the story of a 27-year-old man who was presented to a Salt Lake hospital emergency room Nov. 5, 1984, with complaints of having fallen while showering at home.
"He related that during the previous two weeks he had experienced progressive loss of sensation and strength in both lower extremities, only to lose all sensation and strength acutely and totally in both legs that night," the physicians wrote.
The patient in the account reported by the two doctors said he was an active homosexual and a past IV drug user. He stated that he was also an ordained Catholic priest, who allegedly had been banished to Utah by the church after he was caught in a police raid. He said, further, that he was subsequently asked by the Utah Catholic officials to take a leave of absence from his church duties, the physicians' story said.
What's more, the young patient in the story said he had been diagnosed as having AIDS.
Physicians soon became aware of several inconsistencies. But because of the severity of the patient's complaints and the previous diagnosis of AIDS, he was admitted to the hospital's neurology service with a preliminary diagnosis of myelitis.
During the next 25 days, he submitted to such extensive medical procedures as computerized axial tomography of the brain. He underwent a series of antibiotic and steroid treatments, not to mention four painful spinal taps, enabling the physicians to obtain spinal fluid for evaluation.
Test results were negative, and physicians' observations strengthened their initial impression that "the neurological symptoms were fabricated." A call to a Nebraska hospital confirmed that no diagnosis of AIDS had been made. A second call to Salt Lake Catholic authorities revealed that, "although they had had direct contact with the patient, they had been unable to substantiate his claims of being an ordained priest."
The patient was discharged from the hospital on the 25th day after admission (it's unknown who paid the bill), and after consultation with the psychiatric service, the diagnosis of Munchausen's syndrome was confirmed, Robinson and Latham wrote.
The authors said this was the first reported case in the United States of a patient fabricating a history of AIDS to obtain admission to a hospital. But, according to Nichols, people since have fabricated the illness to get press coverage.
Their motive is a mystery, he said.
"I think it's unusual that someone would want that publicity about a deadly disease," Nichols said. "There may be some satisfaction with public attention, but I find it difficult to believe that these individuals really understand the possible impact of declaring themselves as AIDS patients."