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Polymicrobial Bacteremia and Child Abuse

Polymicrobial Bacteremia and Child Abuse Abstract Sir.—We read with interest Bonadio's recent article1 about polymicrobial bacteremia in children. The author presents an extensive list of underlying conditions associated with this unusual condition. We wish to add child abuse as another important cause of polymicrobial bacteremia. Adult-induced sepsis in children has been described in several reports2-6 as a manifestation of Munchausen syndrome by proxy. This syndrome described by Meadow2 is a variant of child abuse in which parents, usually mothers, fabricate signs and symptoms of illness in their children. In some cases, fabrication is done by deliberate injection of bacteriologically contaminated material. The special features that should suggest exogenously induced bacteremia are the following: (1) recovery of unusual organisms that are not commonly pathogens, (2) development of frequent skin infections at the site of intravenous infusions, (3) absence of an underlying condition or source of infection that would explain the development of polymicrobial References 1. Bonadio WA. Polymicrobial bacteremia in children: an 11-year experience . AJDC . 1988; 142:1158-1160. 2. Meadow SR. Munchausen syndrome by proxy: the hinterland of child abuse . Lancet . 1977; 2:343-345.Crossref 3. Kohl S, Pickering LK, Dupree E. Child abuse presenting as immunodeficiency disease . J Pediatr 1978;93:466-468.Crossref 4. Liston TE, Levine PL, Anderson C. Polymicrobial bacteremia due to Polle syndrome: the child abuse variant of Munchausen by proxy . Pediatrics . 1983;72:211-213. 5. Halsey NA, Frentz JM, Tucker TW, Sproles T, Redding J, Daum RS. Recurrent nosocomial polymicrobial sepsis secondary to child abuse . Lancet . 1983;2:558-560.Crossref 6. Rubin LG, Agelides A, Davidson M, et al. Recurrent sepsis and gastrointestinal ulceration due to child abuse . Arch Dis Child . 1986;61:903-905.Crossref 7. Shnaps V, Frand M, Rotem Y, Tirosh M. The chemically abused child . Pediatrics 1981;68: 119-121. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Polymicrobial Bacteremia and Child Abuse

AMIR, JACOB
American Journal of Diseases of Children , Volume 143 (4) – Apr 1, 1989
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Polymicrobial Bacteremia and Child Abuse

Abstract

Abstract Sir.—We read with interest Bonadio's recent article1 about polymicrobial bacteremia in children. The author presents an extensive list of underlying conditions associated with this unusual condition. We wish to add child abuse as another important cause of polymicrobial bacteremia. Adult-induced sepsis in children has been described in several reports2-6 as a manifestation of Munchausen syndrome by proxy. This syndrome described by Meadow2 is a variant of child abuse in...
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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1989.02150160066011
Publisher site
See Article on Publisher Site

Abstract

Abstract Sir.—We read with interest Bonadio's recent article1 about polymicrobial bacteremia in children. The author presents an extensive list of underlying conditions associated with this unusual condition. We wish to add child abuse as another important cause of polymicrobial bacteremia. Adult-induced sepsis in children has been described in several reports2-6 as a manifestation of Munchausen syndrome by proxy. This syndrome described by Meadow2 is a variant of child abuse in which parents, usually mothers, fabricate signs and symptoms of illness in their children. In some cases, fabrication is done by deliberate injection of bacteriologically contaminated material. The special features that should suggest exogenously induced bacteremia are the following: (1) recovery of unusual organisms that are not commonly pathogens, (2) development of frequent skin infections at the site of intravenous infusions, (3) absence of an underlying condition or source of infection that would explain the development of polymicrobial References 1. Bonadio WA. Polymicrobial bacteremia in children: an 11-year experience . AJDC . 1988; 142:1158-1160. 2. Meadow SR. Munchausen syndrome by proxy: the hinterland of child abuse . Lancet . 1977; 2:343-345.Crossref 3. Kohl S, Pickering LK, Dupree E. Child abuse presenting as immunodeficiency disease . J Pediatr 1978;93:466-468.Crossref 4. Liston TE, Levine PL, Anderson C. Polymicrobial bacteremia due to Polle syndrome: the child abuse variant of Munchausen by proxy . Pediatrics . 1983;72:211-213. 5. Halsey NA, Frentz JM, Tucker TW, Sproles T, Redding J, Daum RS. Recurrent nosocomial polymicrobial sepsis secondary to child abuse . Lancet . 1983;2:558-560.Crossref 6. Rubin LG, Agelides A, Davidson M, et al. Recurrent sepsis and gastrointestinal ulceration due to child abuse . Arch Dis Child . 1986;61:903-905.Crossref 7. Shnaps V, Frand M, Rotem Y, Tirosh M. The chemically abused child . Pediatrics 1981;68: 119-121.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Apr 1, 1989

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