Given these changes from the original case, what is your diagnosis?
What is your diagnostic explanation?
As compared to the long case, this patient is a 20 year old man.
HPI: Same as in the long case. In addition, he has told his parents that he thinks they are working with the FBI to catch him doing something wrong so they can arrest him. He has also scared his parents several times by speaking to someone he says is in the room, but neither of his parents see who he is talking to.
PMH: Same as in the long case.
SH: He is single, a college student. The remaining social history is the same as in the long case.
FMH: Same as in the long case.
ROS: General: reports subjective fevers at times, some fatigue and weight loss; Skin: NO itching or crawling sensation; CV: palpitations and diaphoresis. The rest of ROS is the same as in the long case.
PE: General: Pale and gaunt, patient appears anxious and occasionally seems to be answering to someone in the corner of the room; HEENT: same as in the long case except nares normal this time, and dentition is poor. Rest of PE is the same as in the long case.