A 20-year-old boy presented with fever along with hearing of voices, aggressive behavior, muttering to self since 2 days. Diagnosis is: AIIMS 10; KCET 13; COMEDK 13
**Core Concept**
The patient's symptoms of fever, hearing voices, aggressive behavior, and muttering to self suggest a psychotic episode, likely due to a psychiatric disorder. This presentation is often associated with a delirious state, characterized by altered consciousness, disorganized thinking, and hallucinations.
**Why the Correct Answer is Right**
The correct diagnosis is **Acute Psychotic Disorder**, specifically a **Schizophreniform Disorder** or **Schizophrenia**. The patient's symptoms, such as hearing voices and muttering to self, are indicative of hallucinations and disorganized thinking, which are hallmarks of schizophrenia. The presence of fever may suggest a possible organic cause, such as a **Neuroleptic Malignant Syndrome (NMS)**, a rare but life-threatening side effect of antipsychotic medication.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided, but it could be incorrect if it does not align with the patient's symptoms.
* **Option B:** This option might be incorrect if it suggests a different diagnosis, such as **Bipolar Disorder**, which typically presents with mood swings and not typically with a delirious state.
* **Option C:** This option might be incorrect if it suggests a diagnosis of **Schizoaffective Disorder**, which requires a distinct period of mood disorder symptoms.
* **Option D:** This option might be incorrect if it suggests a diagnosis of **Organic Mood Disorder**, which typically presents with a more gradual onset and less severe symptoms.
**Clinical Pearl / High-Yield Fact**
When evaluating patients with psychotic symptoms, it's essential to consider potential organic causes, such as medication side effects, infections, or metabolic disorders. A thorough medical and psychiatric history, along with a physical examination, can help differentiate between psychiatric and organic causes.
**Correct Answer: C. Schizophreniform Disorder/Schizophrenia**