Factitious illnesses are unique difficulties for physicians.
Patients who present with overt demonstrable symptoms but prove to have a factitious disease, such as Munchausen syndrome, are particularly challenging and fascinating. The pathophysiology is unknown. The relationship of these constellations of personality disorders to the primary syndrome is unclear. For example, this may happen when exogenous material is injected into a patient to produce infections or febrile symptoms. Typically, patients with Munchausen syndrome are male.