Mohammad Imran, Fazalur Rehman Khan, Aurang Zeb.
Fabricated illness (Munchausen Syndrome by Proxy) a report of two babies.
Pak Paed J Jan ;19(2):85-7.

A 10 months old girl was referred from dermatology unit to our department with multiple transverse scars of various sizes and durations on all the four limbs. According to the mother, red lines appear on limbs which then spontaneously split resulting in wounds which bleed. These wounds heal spontaneously or after surgical closure in a few days tine. The patient was the first issue of an unrelated couple. She was delivered normally and had no problems in the past. On examination, she had left club foot (the limb bearing most of the wound marks). There were no other significant findings. We suspected some sort of abuse and she was admitted for observation. During night, the patient suddenly cried. The nurse on duty examined the patient and saw a fresh bleeding incised wound on the lower limb of the patient. The mother insisted that the wound was spontaneous as were the previous ones. On searching, the nurse found a needle and a small scissors with her mother. Next day, suspecting that the mother was the perpetrator, we separated the baby from the mother by shifting the baby to special care nursery, and during the next few days new wounds did not appear. Although the mother never confessed inspite of repeated confrontation by psychiatrist and clinical psychologist, new wounds stopped to appear after separation. The problem was explained to the father, the patient was sent home and asked to come back after 1 month. Futher progress is not known, because the family did not turn up for follow up.

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