Munchausen syndrome presenting as pulmonary talcosis

Acute respiratory failure leading to emergency intubation: An unusual manifestation of Munchausen's syndrome

Munchausen's syndrome is a contrived psychiatric disorder, in which patients present with an intentionally produced or feigned illness with the aim to assume the sick role and to gain medical attention. Patients may even seek the application of invasive procedures, sometimes with serious risk to life. We describe the case of a 38-year-old woman, who repeatedly presented with apparent respiratory failure leading to tracheal intubation and mechanical ventilation. In addition, we present a systematic review of the literature over respiratory and pulmonary manifestations of Munchausen's syndrome. This case report may contribute to the awareness among emergency physicians of Munchausen's syndrome as a differential diagnosis of respiratory failure. Recognition of this psychiatric disease is not only important for correct medical diagnosis and treatment, but also essential in protecting the patients from unnecessary invasive and aggressive medical procedures.

Talc inhalation is a life-threatening condition

A case of rapidly progressive disease and pulmonary hypertension due to chronic cosmetic talc inhalation is presented. Although an uncommon cause of pulmonary hypertension, talc, especially through intravenous administration, should be included in the etiology of parenchymal pulmonary hypertension. In our case talc inhalation was inadvertent, causing fulminant disease leading to the patient's death. To our knowledge, this is the first case of inadvertent talc inhalation causing death in adult patient.