The Baron Has AIDS: A Case of Factitious Human Immunodeficiency Virus Infection and Review

A 31-year-old cachectic intravenous drug user received treatment at in- and outpatient AIDS care facilities for almost one year before the diagnosis of Munchausen syndrome was established. Cases of factitious AIDS have been reported with increasing frequency since the onset of the AIDS epidemic. Patients typically give a complex history of opportunistic infections and present with acute neurological or psychiatric complaints. Few of these patients have a history of Munchausen syndrome. Most are members of groups at high risk for human immunodeficiency virus (HIV) infection and are thus at risk for actually developing the conditions they feign. As multidisciplinary care of HIV-infected patients becomes increasingly broad-based, technical, and expensive, health care providers should be aware of the phenomenon of factitious AIDS. Judicious confirmation of medical history and HIV serologic test results should not be overlooked in clinical facilities that are oriented toward treatment of HIV-infected patients.