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Fraudulent AIDS: a variant of Munchausen's syndrome.

To the Editor.— In a recent issue ofJAMA, Zumwalt and others1described a man with factitious acquired immunodeficiency syndrome (AIDS). The purpose of the man's deception as perceived by the authors, who were also the medical examiners, was to obtain narcotics and defraud the government. Furthermore, they discovered the man died from an overdose of medications that were obtained by his successfully posing as an AIDS victim at multiple hospitals—a feat that may seem difficult to comprehend, since human immunodeficiency virus infection is usually easily and quickly confirmed. We would like to suggest an alternative explanation for the victim's deception. More importantly, we would also like to offer some comments on the role of physicians in providing the means for this man's death. First of all, another diagnosis could perhaps better account for the man's actions and motives: chronic factitious disorder with physical symptoms (DSM-III301.51), more commonly