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Munchausen syndrome by proxy presented as recurrent respiratory arrest and thigh abscess: a case study and overview
Dilşad Foto Özdemir1, Sıdıka Songül Yalçın, Ayşe Zeki
1Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey. dilsad_ozdemir@yahoo.com.
Abstract:
While many physicians are familiar with the sexual or physical abuse of children, there is little awareness about Munchausen syndrome by proxy (MSBP). As case reports of MSBP increase, awareness among physicians is thought to increase as well. We thus present herein a 16-month-old girl who admitted to Hacettepe University İhsan Doğramacı Children's Hospital with the complaint of seizure, recurrent apnea and thigh abscess, who was later diagnosed as MSBP. The case was being followed by the Child Protection Team of the hospital (Haceteppe University Child Protection Unit [HU-CPU]). HU-CPU contributed to the early detection of this case and protected the child from a possible fatal outcome. The mother was confronted for MSBP and refused to take responsibility for her child's symptoms. As seen in this case, when MSBP is suspected, psychiatric evaluation of the mother, evaluation of the mother-child interaction and collection of a detailed family and social history can have a positive impact on the prognosis in these cases. This case report underlines the importance of multidisciplinary team work to share the responsibility and reduce the burden during the treatment process of these difficult and complicated cases.
Insights
Munchausen syndrome by proxy (MSBP) is underrecognized. Early detection and multidisciplinary intervention, as seen in a case of a 16-month-old girl, are crucial for protecting children from harm.
Area of Science:
- Pediatrics
- Child Abuse
- Psychiatry
Background:
- Munchausen syndrome by proxy (MSBP) is a form of child abuse often overlooked by healthcare professionals.
- Increased case reports suggest a need for greater physician awareness regarding MSBP.
Observation:
- A 16-month-old girl presented with seizure, recurrent apnea, and thigh abscess.
- The child was diagnosed with Munchausen syndrome by proxy (MSBP).
- The Hacettepe University Child Protection Unit (HU-CPU) played a vital role in early detection and child protection.
Findings:
- The mother denied responsibility for the child's symptoms, a common feature in MSBP cases.
- Psychiatric evaluation of the mother, assessment of mother-child interaction, and detailed history taking are vital for prognosis.
- Multidisciplinary teamwork is essential for managing complex MSBP cases and reducing clinician burden.
Implications:
- This case highlights the critical importance of recognizing and managing Munchausen syndrome by proxy.
- Enhanced awareness and collaborative approaches among healthcare professionals can improve outcomes for affected children.
- Early intervention by child protection teams can prevent severe consequences and potentially fatal outcomes.
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