Citation

Moon LM, Childress KJ, Isaac R, Adeyemi-Fowode O. J. Pediatr. Adolesc. Gynecol. 2018; 31(6): 637-639.

Affiliation

Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.

Copyright

(Copyright © 2018, North American Society for Pediatric and Adolescent Gynecology, Publisher Elsevier Publishing)

DOI

10.1016/j.jpag.2018.06.011

PMID

29990550

Abstract

BACKGROUND: Medical child abuse is a challenging diagnosis to make, particularly in older children with unusual presenting symptoms. CASE: A 7 year old with complex medical history presented with ano-genital bleeding of unknown origin. Extensive laboratory testing, imaging studies, and diagnostic procedures were negative for any etiology. Forensic testing confirmed the blood in her underwear was a genetic match to the patient. Trial separation from the mother was both diagnostic and therapeutic in this case. SUMMARY AND CONCLUSION: Older children who are victims of medical child abuse may present in a variety of ways, and may even collaborate with the perpetrator in falsifying symptoms. It is important to keep medical child abuse on the differential when the patient's symptoms and work up do not match.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

Medical child abuse; Munchausen by proxy; genital bleeding; pediatric; vaginal bleeding