Malnutrition, a rare form of child abuse: diagnostic criteria.
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.
Piercecchi-Marti
Marie-Dominique
MD
Laboratoire de Médecine Légale, Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France. marie-dominique.pierecchi@mail.ap-hm.fr
Louis-Borrione
Claude
C
Bartoli
Christophe
C
Sanvoisin
Alain
A
Panuel
Michel
M
Pelissier-Alicot
Anne-Laure
AL
Leonetti
Georges
G
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*
D000096:Acetone