Nicholas S. McDuffee, MA, BS

A healthy 17-year-old boy with no psychiatric family history experienced stress-induced, acute-onset catatonia and Bell's mania.

This case highlights the need for timely screening and treatment of Lyme disease and other tick-borne co-infections in patients with neuropsychiatric symptoms in tick-endemic areas.

This case illustrates the complexities of diagnosing factitious disorder in adolescents, in which psychosocial factors play a significant role.