A tale of two viruses : a bipolar disorder patient's path to Varicella Zoster Meningoencephalitis diagnosis in the pandemic era

Abstract

Key Message: The labyrinth of psychiatric diagnoses can often be puzzling, and sometimes, the true pathogenesis lurks within the complex interplay between psychiatric and organic disorders. A high index of suspicion, combined with a broadened diagnostic perspective, is crucial in such scenarios. This case offers an important reminder of the intricate ways in which viral pathogens can affect the CNS and masquerade as psychiatric disorders, emphasizing the importance of thorough evaluation and timely intervention.

Learning Points:

- Beware of Diagnostic Overshadowing: Psychiatric symptoms should not automatically dismiss physical health concerns, as “diagnostic overshadowing” can delay accurate diagnosis and treatment. - Consider Organic Causes: When patients with psychiatric disorders exhibit atypical or worsening symptoms, clinicians should consider organic etiologies, especially during public health crises like the COVID-19 pandemic. - Timely Evaluation Is Crucial: Swift and thorough evaluation can lead to timely intervention and improved patient outcomes, even when symptoms initially appear to be related to mental health.