Genital self-mutilation in a suicide attempt: a rare sequela of a hypochondriacal delusion of infection with HIV

Cases of genital amputation require a careful investigation, since they may be the result of self-inflicted injuries, assaults, animal predation, or post-mortem body mutilation. In the present case, an 81-year-old man affected by liver cirrhosis and dementia and suffering from sexual disinhibition was found lying half-naked and unconscious in his courtyard; profuse bleeding in the perineal area and the absence of the external genitalia were observed. The victim was transferred to hospital and underwent surgical emergency treatment, but he died 2 days later. No sharp tools were found on the scene. Moreover, the autopsy did not reveal any defense or tentative wound on the body and no blood stains on the hands of the victim. Several linear scratches were detected close to the edges of the wound; according to the surgical report, these scratches were clean-cut in the lower part and crenated and infiltrated by blood in the cranial part. Although the medical history of the man could be consistent with self-mutilation, it was not possible to rule out the involvement of other people, including the possibility of an attempt by his relatives to cover up what may have been a self-amputation. Furthermore, the victim’s dog vomited parts of the man’s genitalia while being transported to a dog shelter. Similar cases have rarely been published in the current forensic literature.

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“…Suicidal attempts through GSM are rare and often unsuccessful, while GSM is more frequent in cases of self-harm [2,7,[30][31][32].…”

Section: Analysis Of the Injury Patternsmentioning

confidence: 99%

A fatal and unusual genital mutilation in an elderly man as a result of sharp force injuries and domestic dog predation

Simonit

Moreschi

Desinan

2022

Forensic Sci Med Pathol

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“…Patients may attempt to physically remove the infestation from their bodies. Resulting damage to skin, hair, eyes, genitals, and other body parts is well described [ 4 , 22 , 23 ]. Secondary infections may complicate self-mutilation behaviors and may be the inciting event that leads to referral to an infectious disease specialist.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Delusional Infestation

Laupland

Valiquette

2016

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Although the practice of infectious diseases involves a broad range of surgical and medical disciplines, interactions with psychiatry are infrequent. Delusional infestation is a condition where an individual has a firmly fixed false belief that they have an infection. Delusional infestation challenges the infectious diseases specialist who must diligently rule out the presence of a true infection. However, perhaps, more importantly, we may need to initiate therapy with neuroleptic medications for which we may have little specific knowledge and experience. In this note we review the diagnosis and management of patients with delusional infestation.

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“…The delusion can result in damage to the skin, hair, eyes and other family members, as they try to "clean" the infestation with dangerous substances or elements including fire and electricity (6,44,45). This condition can be affected by a large array of complications as listed in Table 3 (6,12,35).…”

Section: Drugs or Conditionsmentioning

confidence: 99%

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

Olivera¹,

Villamil²,

Moreno³

et al. 2017

Case reports

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Introduction: Delusional infestation is a rare psychiatric disorder defined as a condition in which the patient has the unshakable belief and perception of being infested with parasites. Its treatment is difficult, and frequently includes antipsychotic medications (such as olanzapine or aripiprazole). Non-pharmacological treatment, particularly psychotherapy, can be used for less severe cases. Dermatologists and psychiatrists must take a multi-disciplinary approach (preferably in a psycodermatology dedicated clinic) since this type of patients sometimes refuse treatment. Case description:A 53-year-old female businesswoman describes a clinical history of five years of visual hallucinations, depressive symptoms, and generalized pruritus, along with the use of toxic substances to "clean" her skin and cloths. She reports similar symptoms in some relatives but they were not evaluated. Blood tests and analyses of the "specimen" brought by the patient were performed, yielding negative results. The patient had never been assessed by any specialist, and showed disoriented during the consultation. Follow-up was not possible due to the reluctance of the patient to follow the indications and seek psychiatric treatment. Moreover, the patient did not respond to further communication attempts.

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Genital self-mutilation in a suicide attempt: a rare sequela of a hypochondriacal delusion of infection with HIV

Cited by 3 publications

References 7 publications

A fatal and unusual genital mutilation in an elderly man as a result of sharp force injuries and domestic dog predation

A fatal and unusual genital mutilation in an elderly man as a result of sharp force injuries and domestic dog predation

Delusional Infestation

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

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