Caregiver-Fabricated Illness in a Child: A Case Report of Three Siblings

Abstract

Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver inducing a child's illness, leading to unnecessary and potentially harmful medical procedures and treatments. This condition can result in significant morbidity and mortality. We present the case of three siblings in Tunisia who were poisoned with chloralose by their own mother. The symptoms that the children presented with led to misdiagnoses, which resulted in the death of two of the children. Characteristics of the clinical presentation are articulated, followed by a discussion of the legal measures that apply to the offender and the role of physicians, nurses, and medicolegal experts involved in such a complex medical situation.

Síndrome de Münchausen por Procuração: Revisão Integrativa

“…A Síndrome de Münchausen por Procuração (SMP) é definida como uma doença induzida ou fabricada em uma criança pelo seu responsável (3,6,26,27,9,(16)(17)(18)20,21,24,25) , sendo que a mãe é a principal perpetradora, ou seja, a agressora (7,15,25) . A criança pode vir a contribuir com o infrator na fabricação da doença e pode se tornar um perpetrador futuramente (3,5,26) .…”

“…A Síndrome de Münchausen por Procuração (SMP) é definida como uma doença induzida ou fabricada em uma criança pelo seu responsável (3,6,26,27,9,(16)(17)(18)20,21,24,25) , sendo que a mãe é a principal perpetradora, ou seja, a agressora (7,15,25) . A criança pode vir a contribuir com o infrator na fabricação da doença e pode se tornar um perpetrador futuramente (3,5,26) . A mãe se torna a principal agressora devido à proximidade com o filho, o vínculo maternal existente favorece a indução/fabricação de uma determinada patologia, incentivando a contribuição da criança para prosseguir com as histórias e podendo futuramente se tornar um adulto perpetrador iniciando uma nova geração de agressores.…”

The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

“…This under-5 population is the age group with the highest incidence of poisoning [1-3, 7, 12-14]. In LMICs, neglect may present as accidental poisoning as children are often left unsupervised, while child abuse may present as intentional or occult poisoning [15][16][17].…”

A Prospective Study to Assess the Value of Liquid Chromatography-Tandem Mass Spectrometry in the Management of Paediatric Poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

“…(1-3, 7, [12][13][14] In LMICs, neglect may present as accidental poisoning as children are often left unsupervised, while child abuse may present as intentional or occult poisoning. (15)(16)(17) The role of investigations in poisoning is controversial but may be of bene t in occult poisoning, where it is di cult to con rm the presence and cause of poisoning. Point-of-care urine drug screen (POCUDS) testing is cost effective and readily available, able to give immediate results but has several disadvantages, such as, a high false positive rate; can only screen for a limited number of drugs; inability to quantify the drug; inability to name the drug, as it can only identify the drug class and the risk of false negatives if the drug in question is below the threshold cut-off for detection.…”