New-Onset Mania With Psychotic Features in a Patient With DiGeorge Syndrome, HIV, Syphilis, and Pulmonary Hypertension.

This case report describes a 34-year-old man with HIV and DiGeorge syndrome who experienced his first documented manic episode with psychotic features. On admission, he exhibited psychomotor agitation, catatonic behavior, perseveration, disorganized thoughts, hyper-religiosity, auditory hallucinations, and grandiose delusions. Initial treatment with antipsychotics was complicated by autonomic instability, limiting therapeutic options. Further evaluation revealed syphilis and pulmonary hypertension, which further complicated his hospital course. This case highlights the complexities of managing psychiatric symptoms in patients with DiGeorge syndrome and HIV, as well as the increased risk for first-break psychosis associated with a 22q11.2 deletion.