Jornal de Cuidados Intensivos e Críticos Acesso livre

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Skin Ecchymosis with Schizophrenia Revealed Hidden Bone Fractures

Zhao Xiaojing, Niu Zequn and Wang Gang

Clinical diagnosis can be influenced and delayed when patients with mental disorders cannot provide reliable medical history and cooperate with physical examinations, as well as their family members cannot evaluate the progress of the disease accurately. We present a case report of a female with schizophrenia who was admitted with convulsion and fever accompanied by skin ecchymosis of the upper limbs. She was initially diagnosed as “septic shock”, had been treated with antibiotics and fluid resuscitation in a local hospital for five days, and then was transferred to our hospital because of continuing confusion and low-grade fever. After repeatedly checking medical history and detailed physical examinations, the patient was eventually diagnosed as multiple fractures with the upper limbs and shoulders, and recovered a few days later after necessary surgical intervention.