Munchausen's syndrome, or chronic factitious illness, is the diagnosis applied to a patient who chronically seeks admission to hospitals, with apparently acute illnesses. These are due to self-inflicted, self-mutilative lesions associated with misleading physical and laboratory findings as well as an exaggerated, distorted medical history. These patients are frequently dramatic in their presentation of symptoms and are often sophisticated and knowledgeable in medical terminology. As a result of their confusing, skillful mimicry, they may be subjected to many unnecessary medical and surgical procedures.
Most pediatricians have encountered malingering or such simulated symptoms as factitious fever in children and adolescents. Major chronic factitious illness or Munchausen's syndrome is very rare in the pediatric age group.1
Report of a Case.—The patient is a 15½-year-old girl who had been adopted at age 2 years in Japan and reared in Hawaii as an only child. Her first major hospitalization occurred at age