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April 1989, Vol 143, No. 4 >
Article | April 1989

Polymicrobial Bacteremia and Child Abuse FREE

JACOB AMIR, MD
Am J Dis Child. 1989;143(4):444. doi:10.1001/archpedi.1989.02150160066011.
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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.
3 +
Kohl S, Pickering LK, Dupree E.  Child abuse presenting as immunodeficiency disease . J Pediatr 1978;;93:466-468.
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.
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.
7 +
Shnaps V, Frand M, Rotem Y, Tirosh M.  The chemically abused child . Pediatrics 1981;;68: 119-121.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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.
3 +
Kohl S, Pickering LK, Dupree E.  Child abuse presenting as immunodeficiency disease . J Pediatr 1978;;93:466-468.
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.
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.
7 +
Shnaps V, Frand M, Rotem Y, Tirosh M.  The chemically abused child . Pediatrics 1981;;68: 119-121.

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