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Recurrent sepsis and gastrointestinal ulceration due to child abuse
Archives of Disease in Childhood
|September 1, 1986
Insights
A child
Area of Science:
- Pediatric Medicine
- Forensic Medicine
- Child Psychology
Background:
- Gastrointestinal ulceration and sepsis are serious conditions in children.
- Recurrent infections can indicate underlying medical issues or external factors.
Observation:
- An 11-year-old girl presented with severe upper gastrointestinal ulceration.
- She experienced repeated episodes of polymicrobial bloodstream infections linked to intravenous catheters.
- Initial evaluations did not reveal an identifiable medical cause.
Findings:
- The patient's condition significantly improved after her parents were excluded from her care.
- This clinical course strongly suggests suspected child abuse, consistent with Meadow's syndrome.
- The improvement upon separation from caregivers supports non-accidental trauma as the etiology.
Implications:
- This case highlights the importance of considering non-accidental trauma in unexplained pediatric illnesses.
- Meadow's syndrome, or Munchausen by proxy, requires a high index of suspicion.
- Early recognition and intervention are crucial for the child's safety and well-being.
Abstract:
An 11 year old girl developed progressive upper gastrointestinal ulceration and recurrent episodes of intravenous catheter associated polymicrobial septicaemia. Evaluation failed to establish a cause. After exclusion of the parents and careful surveillance of the patient she improved, supporting the diagnosis of suspected child abuse (a form of Meadow's syndrome).