Munchausen syndrome by proxy presenting as hearing loss.
OBJECTIVE
To review the diagnosis of Munchausen syndrome by proxy, a factitious disorder, in which symptoms are induced or feigned, usually in a child, by the caregiver. The involved caregiver seeks to gain attention or sympathy and often has a psychological need to maintain the sick role. We highlight the diagnostic difficulties and factors that may help with diagnosis in an otolaryngology setting.


METHODS
We present the case of Munchausen syndrome by proxy presenting with hearing loss in a five-year old boy, who was diagnosed eight years after his initial presentation. A literature review of Munchausen syndrome by proxy cases presenting with ENT symptoms is provided.


CONCLUSIONS
Munchausen syndrome by proxy is a diagnosis that otolaryngologists should be aware of, particularly where recurrent or persistent illnesses in children, especially those involving otological symptoms, are refractory to the usual treatments.
Department of ENT,Sheffield Children's Hospital,UK.
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Ashraf
Department of ENT,Sheffield Children's Hospital,UK.
M S
MS
Thevasagayam
D002675:Child, Preschool; D034381:Hearing Loss / Q000175:diagnosis / Q000523:psychology*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*; D012008:Recurrence; D012017:Referral and Consultation