Organophosphate insecticide poisoning with monocrotophos-induced fabricated illness in a 7-year-old girl with refractory seizures over a 4-year period.
Chisambo Mwaba, Chalilwe Chungu, Ronald Chola, Kafula Lisa Nkole, Somwe Wa Somwe, Evans Mpabalwani
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引用次数: 0
Abstract
Munchausen syndrome by proxy is a form of abuse in which an adult, usually the mother, deceives health workers by exaggerating, falsifying or directly inducing psychological or physical symptoms in the child victim for psychological gratification. In 2013, the American Academy of Pediatrics coined the term 'caregiver-fabricated illness in a child' to describe this form of child abuse. A 7-year-old girl had many encounters with health workers over a period of 4 years and presented with evolving clinical features including refractory seizures and red urine for which she was followed up as a case of acute intermittent porphyria. She was later discovered to be the victim of chronic monocrotophos organophosphate poisoning by her mother. If all medical staff who manage children are to avoid becoming inadvertent participants in medical child abuse, this case report is an important reminder that a high index of suspicion is warranted in cases which present a diagnostic dilemma and who respond unexpectedly to treatment.Abbreviations AIP: Acute intermittent porphyria; APSAC: American Professional Society on the Abuse of Children; ASM: anti-seizure medication; CFIC: caregiver-fabricated illness in a child; CT: computed tomography: DVT: deep vein thrombosis; EEG: electroencephalogram: ESR: erythrocyte sedimentation rate; HDW: high-dependency ward; ICU: intensive care unit; LFT: liver function test; MBP: Munchausen syndrome by proxy; NICU: neonatal intensive care unit; RFT: renal function test; TB: Tuberculosis; UTH-CH: University Teaching Hospitals Children's Hospital.
孟乔森代理综合症是一种虐待形式,在这种虐待中,成年人,通常是母亲,通过夸大、伪造或直接诱使儿童受害者出现心理或身体症状来欺骗卫生工作者,以获得心理上的满足。2013年,美国儿科学会(American Academy of Pediatrics)创造了“看护人捏造的儿童疾病”一词来描述这种形式的虐待儿童行为。一名7岁女孩在4年期间多次与卫生工作者接触,并表现出不断变化的临床特征,包括难治性癫痫发作和红色尿液,因此作为急性间歇性卟啉症病例对她进行了随访。后来,她的母亲发现她是慢性有机磷单效磷中毒的受害者。如果所有管理儿童的医务人员都要避免无意中成为医疗虐待儿童的参与者,那么本病例报告是一个重要的提醒,即在出现诊断困境和对治疗反应意外的病例中,高度怀疑是有必要的。AIP:急性间歇性卟啉症;美国虐待儿童专业协会;ASM:抗癫痫药物;CFIC:照顾者捏造的儿童疾病;CT:计算机断层扫描;DVT:深静脉血栓形成;EEG:脑电图:ESR:红细胞沉降率;HDW:高依赖病房;ICU:重症监护病房;LFT:肝功能检查;MBP:代用Munchausen综合征;NICU:新生儿重症监护病房;RFT:肾功能检查;结核病:肺结核;UTH-CH:大学教学医院儿童医院。
期刊介绍:
Paediatrics and International Child Health is an international forum for all aspects of paediatrics and child health in developing and low-income countries. The international, peer-reviewed papers cover a wide range of diseases in childhood and examine the social and cultural settings in which they occur. Although the main aim is to enable authors in developing and low-income countries to publish internationally, it also accepts relevant papers from industrialised countries. The journal is a key publication for all with an interest in paediatric health in low-resource settings.