John Thompson, a 14-year-old male, was brought in by his father for complaints of fear of being exposed to disease.

Patient Scenario

John Thompson, a 14-year-old male, was brought in by his father for complaints of fear of being exposed to disease. He is an eighth grader in middle school. His symptoms started after the pandemic and persisted since he excessively washes his hands and refuses to touch doors without gloves. His hands are frequently dry and chafing from excessive washing. He washes his hands for approximately two minutes and turns his hand washing routine. He washes his hands for at least 30 times per day and sanitizes all doors and handles in the house daily. Despite the lifting of the mask mandate, John continues to wear a mask when he is out in public.in school, John sanitizes his desk and chairs before sitting down. He also refuses to eat lunch in the cafeteria, as he is worried that taking off his mask in the building filled with kids will expose him to germs.

He prepares his own lunch and eats outdoors. This ritualistic behavior has become distracting to his class. distracting in his classrooms. His counselors and several teachers have reached out to his parents regarding their concerns. John has been attending cognitive behavior therapy to help with his anxiety. Last week, his parents took him to his primary care provider after his hands became so excoriated that they were bleeding. His doctor referred him to your clinic for evaluation.