Page 112 - JCBP-3-3

Journal of Clinical and

Basic Psychosomatics

CASE REPORT
Psychogenic fever and palpitations in a patient

with autonomic nervous system dysfunction: A
case report

1
Rong Chen 1,2 and Rongjing Ding *
1 Department of Rehabilitation, Peking Union Medical College Hospital, Beijing, China
2 Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
(This article belongs to the Special Issue: Advancements in Psycho-cardiology Medicine: Bridging
Clinical and Biological Insights)

Abstract
Mental health disorders are prevalent in cardiovascular disease patients, yet often
remain under-recognized. Psychogenic fever (PF), a psychosomatic condition
triggered by stress, may present as a fever of unknown origin, complicating the
diagnostic process. This case report describes a 58-year-old male diagnosed
with PF, a stress-induced psychosomatic disorder associated with autonomic
*Correspondent author: nervous system (ANS) dysfunction. The patient presented with a 1-year history of
Rongjing Ding
(drj2003@vip.163.com) recurrent low-grade fever and palpitations, which remained unexplained despite
comprehensive laboratory and imaging evaluations. Psychometric assessments
Citation: Chen R, Ding R. revealed chronic stress, mild depression, and moderate anxiety, suggesting
Psychogenic fever and palpitations
in a patient with autonomic nervous psychological stress as the potential cause of PF. ANS evaluation indicated mild
system dysfunction: A case impairment in heart rate variability. The patient’s significant improvement with anti-
report. J Clin Basic Psychosom. anxiety and antidepressant treatment confirmed the diagnosis of ANS dysfunction
2025;3(3):106-115.
doi: 10.36922/jcbp.4864 and PF. This case highlights the importance of incorporating psychometric and
physio-psychological assessments into the diagnostic workup for unexplained
Received: September 16, 2024
fever, advocating for the consideration of mental health disorders after ruling out
1st revised: November 13, 2024 organic causes.
2nd revised: December 16, 2024
3rd revised: January 5, 2025 Keywords: Psychogenic fever; Autonomic nervous system dysfunction; Cardiology;
Accepted: January 10, 2025 Psychosomatic disorder; Anxiety; Palpitations
Published online: February 14,
2025
Copyright: © 2025 Author(s). 1. Background
This is an Open-Access article
distributed under the terms of the Mental health disorders are prevalent among patients with cardiovascular diseases
Creative Commons Attribution (CVDs) in both Chinese and Western populations. Accumulating evidence suggests
1
License, permitting distribution,
and reproduction in any medium, a bidirectional relationship between mental health disorders and CVDs. For instance,
provided the original work is depression (hazard ratio: 1.44; 95% confidence interval [CI]: 1.27 – 1.63) and anxiety
properly cited. (relative risk: 1.41; 95% CI: 1.13 – 1.76) are associated with significantly increased CVD-
2,3
Publisher’s Note: AccScience related mortality. However, the recognition rate of mental health issues in CVD patients
Publishing remains neutral with at general hospitals remains alarmingly low, with only about 4% of cases identified in
regard to jurisdictional claims in 4
published maps and institutional outpatient clinics. This under-recognition may result in frequent hospital readmissions,
affiliations. increased healthcare utilization, and a diminished quality of life. 5

Volume 3 Issue 3 (2025) 106 doi: 10.36922/jcbp.4864