title: Malnutrition, a rare form of child abuse: diagnostic criteria.
abstract: Infantile malnutrition is often difficult to diagnose as it is rarely observed in industrialized countries. It may be associated with physical violence or occur in isolation. The essential clinical sign is height and weight retardation, but malnutrition also causes a variety of internal and bone lesions, which lead to neuropsychological sequelae and death. We report a rare case of death by malnutrition in a female child aged 6 1/2 months. The infant presented height and weight growth retardation and internal lesions related to prolonged protein-energy malnutrition (fat and muscle wasting, thymic atrophy, liver steatosis) resulting in a picture of marasmus or kwashiorkor. We detail the positive and negative criteria that established the diagnosis of abuse, whereas the parents had claimed a simple dietary error.
authors.affiliation: Laboratoire de Médecine Légale, Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France. marie-dominique.pierecchi@mail.ap-hm.fr
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Piercecchi-Marti
authors.forename: Claude
authors.initials: C
authors.lastname: Louis-Borrione
authors.forename: Christophe
authors.initials: C
authors.lastname: Bartoli
authors.forename: Alain
authors.initials: A
authors.lastname: Sanvoisin
authors.forename: Michel
authors.initials: M
authors.lastname: Panuel
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Pelissier-Alicot
authors.forename: Georges
authors.initials: G
authors.lastname: Leonetti
mesh_terms: D000096:Acetone / Q000032:analysis; D001646:Bile / Q000737:chemistry; D001827:Body Height; D001835:Body Weight; D001921:Brain / Q000473:pathology; D002100:Cachexia / Q000473:pathology; D002649:Child Abuse / Q000175:diagnosis*; D003681:Dehydration / Q000473:pathology; D005234:Fatty Liver / Q000473:pathology; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D007223:Infant; D010179:Pancreas / Q000473:pathology; D011502:Protein-Energy Malnutrition / Q000175:diagnosis*
chemical_list: D000096:Acetone