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Malnutrition, a Rare Form of Child Abuse: Diagnostic Criteria

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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 6½ 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.
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Keywords: abuse; forensic science; kwashiorkor; malnutrition; marasmus

Document Type: Research Article

Affiliations: 1: Laboratoire de Médecine Légale, Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France. 2: Service de Chirurgie Pédiatrique, CHU Timone-Enfants, 264 rue Saint-Pierre, 13385 Marseille Cedex 5, France. 3: Service de Radiologie, CHU Nord, Chemin des Bourrelys, 130016 Marseille.

Publication date: 2006-05-01

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