Factitious Fever Presenting as Fever of Unknown Origin in a Young Woman: A Case Report

A 23-year-old woman presented with refractory anemia and a 1-month history of relapsing fever. The patient had been followed up at another hospital for fever of unknown origin and refractory anemia for 2 years. Upon admission to our hospital, repeated body temperature measurements and a nurse’s inspection revealed that the patient had been artificially heating the external auditory canal where the temperature was measured to simulate fever. No temperatures exceeding 38℃ were recorded after the nursing staff removed objects capable of altering measurements, confirming factitious fever as the cause. We report this case to highlight the importance to clinicians who care for patients with fever of unknown origin despite careful and appropriate evaluation.