I love (doctor) shopping…

Key words: Fever, Hypogammaglobulinemia, Mother, Münchausen by proxy

A thirteen-year-old boy presented with recurrent fever for two years and was checked up in several hospitals with the only outcome of hypogammaglobulinemia. He could not go to school for 90 days. He underwent clinical examination and lab tests that showed negative results and no fever. A moderate hypogammaglobulinemia was confirmed but not as cause of the fever. The patient was therefore examined for 24 hours to check fever and his clinical status directly. Every time he was afebrile. “Factitia fever” was suspected and the patient addressed to a neuropsychiatric evaluation that evidenced: “fear of competition with classmates and a pathological relationship with his mother”. So, neuropsychiatric procedure was suggested. His mother seemed to understand, but after a few minutes she asked: “Who is the best doctor in the Clinic? I would like to take my son to check his hypogammaglobulinemia”. And a new doctor shopping was starting again…