Introduction/Objectives:
This research paper introduces a patient who, within the psychotic perceptions, a night before being hospitalized, in a short time interval (2 hours), drank an average of 10 liters of water in 2 hours. Hypotonic hyperhydration has developed and led to water poisoning with a developing polymorphic symptomatology at the somatic level.
Participants, Materials/Methods:
The patient (A.B. born in 1988) had initial psychological problems 6 months prior to being hospitalized in August 2003, at the age of 15. During 2003 and 2004 he was treated four times with the following diagnosis: Dg.F23.0 and F20.1. As of 2004 and until March 2007 the patient reported regularly for control examinations and was taking his therapy. He was in a relatively stable remission until 7 days ago, before coming to our clinic. A night before being hospitalized, in a short time interval (2 hours), he drank some 10 liters of water. Consumed with his psychotic experiences, he drank larger quantities of water to destroy “a growing mushroom in his stomach that was killing him”. Nausea, vomiting, uncontrolled movements and spasms of the entire body have occurred, followed by a series of epileptic seizures of Grand-mal type (according to data provided by parents), with mouth foam, micturition and loss of conscience. Several urgent exams have been done: lab tests, screening test on narcotics and other psychoactive substances, internist', infectologist's, neurologist's procedures, abdominal ultrasound, EEG, brain CT
Results:
The patient spent 12 hours under observation at the Emergency Center. After administered therapy (Diazepam vials 20 mg – i.m./inf. Ringer-lactate + hypertonic solution of NaCl) he is of a clear conscience, properly orientates in every direction, communicative, without conscience crisis, corrected lab values (Na 141 mmol/l, blood sugar 3, 6 mmol/l). Checkup EEG normal. After conducted checkups with the internist, neurologist and infectologist, the patient was admitted to psychiatric clinic for continued treatment.
Conclusions:
This case study was to point the attention of a doctor – psychiatrist to unpredictability of a clinical course of psychotic process. Despite the regular checkups and prescribed therapy, the patient had a worsening psychological status followed by intensive psychotic perceptions, where he consumed large quantities of water. It led to polymorphic-somatic problems, which ultimately might have led to patient's death.
