Unexplained destructive nasal lesions in half-brothers: A possible case of Munchausen syndrome by proxy

Int J Pediatr Otorhinolaryngol. 2019 Aug:123:75-78. doi: 10.1016/j.ijporl.2019.04.029. Epub 2019 Apr 25.

Abstract

Munchausen syndrome by proxy (MSBP) is a condition diagnosed when a caregiver knowingly fabricates or inflicts illness on another for his/her own gain. Typical cases of MSBP detected by otolaryngologists involve facial trauma or otologic injury, while descriptions involving the nose are rare. Destructive nasal lesions have a broad differential diagnosis and may require visits to numerous specialists, placing strain on both the patient and the healthcare system. Early recognition of MSBP in patients with chronic nasal destruction may prevent such unnecessary strain. We present a case of MSBP involving two half-brothers with unexplainable nasal destruction and discuss the literature and current recommendations for managing the diagnosis.

Keywords: Child abuse; Factitious disorders; Munchausen's syndrome by proxy; Nasal destruction; Nasal erosion.

Publication types

  • Case Reports

MeSH terms

  • Chronic Disease
  • Diagnosis, Differential
  • Epistaxis / etiology*
  • Humans
  • Infant
  • Male
  • Munchausen Syndrome by Proxy / complications*
  • Munchausen Syndrome by Proxy / diagnosis*
  • Nose / injuries*
  • Nose Deformities, Acquired / etiology*
  • Siblings