A sixteen-year-old Colombian lost in Spain
First contact with the patient
“This is Viktor, our son, doctor,” the parents say, pushing the boy into your surgery´s door.
A medium-tall, thin boy stands in front of you. He has several irregularly trimmed beards on his face, greasy untreated hair falling carelessly in his face. He doesn't even seem to be changing his clothes for clean ones in recent days.
Viktor doesn't communicate much, he looks at the ground all the time. The words are taken over by the parents.
“We come from Colombia, Viktor is our oldest son, we have lived in Spain since his birth. We have three more children,” explains Viktor's mother.
When you ask, when they started noticing changes in Viktor's behaviour, both father and mother answered almost unanimously. “That was about half a year ago, but the troubles have significantly worsened over the last three weeks.”
“He started acting weird. He locked himself in the room, avoiding contact with his family, refusing to eat what my wife cooked. The only food he was willing to eat were ready meals from the supermarket in closed containers. It has been going on for half a year, but now it is much more intense.” says the father. “I was mad at him, I thought it was just pubescent spite,” he adds.
“The strange behaviour kept escalating. He was still looking for something in his room, but he didn't tell us what. And when he left his room, he kept turning over his shoulder and looking around,” says the mother excitedly.
OK, I got it.
This virtual patient case was created on the basis of clinical practice outside the EU and may, therefore, include an off-label practice.
I agree with playing a virtual patient case authored outside the EU. I will not draw any consequences from this case for my own or any other practice, as this case may contain unapproved use of an approved drug.