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The bacteriologically battered baby: another case of Munchausen by proxy
Abstract:
We present a case in which a mother who had had self-inflicted infections as a teenager also caused life-threatening infections in her year-old child. After testing for and treating various immunologic deficiencies without success, it was apparent that the infection was caused by contamination of intravenous sites. Strict isolation of the patient, with restricted and observed visitations by the mother, was the critical step in stopping the infections. Because the woman took her child to several emergency departments, this case is presented to alert emergency personnel to this entity and to explain some of the dynamics and the social issues that cause the problem.
Insights
A mother caused life-threatening infections in her child through self-contamination of intravenous sites. Strict patient isolation and controlled visitation were key to resolving the infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Medical Case Reports
Background:
- Recurrent, life-threatening infections in a pediatric patient prompted investigation.
- Previous history of self-inflicted infections in the mother raised concerns.
Observation:
- Despite extensive testing for immunologic deficiencies, no underlying cause was found.
- Infections were traced to the contamination of intravenous sites.
- The mother's presence and access were identified as the source of contamination.
Findings:
- The mother intentionally contaminated her child's intravenous lines, leading to severe infections.
- Isolation of the child and supervised visitation by the mother successfully halted the infections.
- The case highlights a rare form of medical child abuse or neglect.
Implications:
- Emergency department personnel should be aware of this rare clinical presentation.
- Understanding the psychosocial dynamics is crucial for diagnosis and management.
- This case underscores the importance of considering non-accidental causes of recurrent infections in children.