Fever and neurological deterioration in a patient admitted to Psychiatry: a diagnostic challenge
DOI:
https://doi.org/10.32818/reccmi.a11n2a14Keywords:
neuroleptic malignant syndrome, malignant catatonia, electroconvulsive therapy, differential diagnosis, shared careAbstract
A 41-year-old woman with a history of schizoaffective disorder was admitted to the Psychiatry Department due
to psychomotor agitation. During hospitalization, she developed a progressive clinical picture of fever, generalized rigidity, mutism, hypomimia and disconnection from the environment. Exposure to antidopaminergic drugs initially suggested neuroleptic malignant syndrome. However, the absence of response to dantrolene, the moderate elevation of creatine kinase (CK) and the catatonic phenotype led to diagnostic reconsideration, raising the possibility of malignant catatonia. Shared care between Internal Medicine and Psychiatry enabled integration of the clinical course, broadening of the differential diagnosis and guidance of therapeutic management.
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Copyright (c) 2026 Mayte García-Wehinger, Marta Ingelmo-Hidalgo, Paola María Tarabini-Castellani-Ciordia, Laureano Ribacoba-Bajo, Agustín Martínez-Berriochoa
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