[Delusional disorders in the course of tick-born encephalitis and borreliosis in patients with hemophilia A and posttraumatic epilepsy--diagnostic and therapeutic difficulties].

The aim of our work was to present the difficulties of the diagnosis and treatment which occurred during hospitalization of a 22-year-old patient diagnosed with type A hemophilia, posttraumatic epilepsy and carrier state of viral hepatitis C. The patient was transferred from Psychiatric Ward of Hospital in Parczew to the Psychiatric Clinical Hospital of Medical University in Lublin due to difficulties in settlement of diagnosis and to lack of the treatment effects. The anamnesis results showed that patient had triple febrile episodes after a trip to Romania; the last one included extreme excitement with suicidal attempt, nihilistic and catastrophic delusions. A co-traveler colleague was diagnosed with borreliosis. In our clinical ward many diagnostic procedures were conducted, obtaining significant increase of Borrelia burgdorferi antibodies, due to which suitable treatment was initiated and minimum improvement of psychical state was obtained. The patient was tested many times by internist, neurologist, and specialist in infectious diseases. In the CT and EEG test no pathological state was revealed in CNS, only the results of the test in the direction of tick bone encephalitis (TBE) showed TBE. During a 3-month period a schizophreniphorm syndrome was observed: he refused consumption of meals, behaved aggressively, had auditory hallucinations, expressed many delusions, was periodically in disturbed consciousness, turned himself in many famous characters (e.g. Wlad Palownik, Pope, Koziolek Matolek, Boguslaw Linda). After four months of hospitalization we reached full remission of physical and mental state and the patients was discharged from hospital.