Elsevier

Burns

Volume 26, Issue 5, 1 August 2000, Pages 504-506
Burns

Case report
Bizarre paediatric facial burns

https://doi.org/10.1016/S0305-4179(00)00003-6Get rights and content

Abstract

Child abuse and neglect account for a significant number of paediatric burn injuries. It is of great importance because of the high mortality, high frequency of repeated abuse, as well as the physical, psychological and social sequelae that it causes. Burn abuse is often under-recognized and under-reported because it is difficult to define non-accidental injury. On the other hand, false accusation of burn abuse is extremely damaging to the family. Bizarre and unusual burn injuries can be caused by accident and should not automatically be assumed to be deliberate injury. Three boys of age 1–7 years with bizarre facial burns were admitted to the Burns Unit at the Prince of Wales Hospital between February 1995 and July 1999. One was burned by his baby-sitter with hot water steam and the other two were burned by their mothers with hot boiled eggs. The unusual causes of their burns raised the suspicion of child abuse and formal investigations were carried out by the Social Services Department. Detail assessment including a developmental history of the child and the psychosocial assessment of the family revealed that these three boys were burned because of poor medical advice and innocent cultural belief.

Introduction

While child abuse by burning has been widely reported, it is often difficult to draw the line between accident injury and deliberate abuse [1]. It is our responsibility to maintain a high index of suspicion and have the legal obligations to report suspicious or deliberate injury. However, false accusation of non-accidental injury is extremely damaging to the family. Unusual and bizarre cause and distribution of burns can be caused by accident and should not automatically be assumed to be deliberate injury.

Three boys of age 1–7 years were admitted to the Burns Unit at the Prince of Wales Hospital between February 1995 and July 1999. They had bizarre facial burns caused by hot water steam and freshly boiled eggs. Suspicion of the possibility of non-accidental burns when they first occurred was voiced. Nevertheless, they were accidental burns caused by their mothers and baby-sitter as a result of innocent cultural belief and poor medical advice. In other words, they were burned in good faith as a result of misguided action by their parents or other.

Section snippets

Case 1

A 1 year-old boy was brought to a general practitioner by his parents because of a persistent productive cough and runny nose. His parents were advised to give this child some ‘steam’ inhalation to facilitate the coughing up of the sputum. The message was conveyed to the baby-sitter and the parents went out to work. In order to carry out the instruction, the baby-sitter put the kettle on and forced the head of the baby boy into the steam from the boiling water. It was not until after a few

Discussion

Child abuse by burning is a serious crime that leaves the child with permanent physical and psychological scars. Burn abuse is costly in terms of pain, suffering and health care. The socioeconomic and psychological impact on the abused victims through life is incalculable [2]. Unfortunately child abuse and neglect continue to account for a significant number of paediatric burn injuries. Deliberately inflicted burns and scalds are found in 10–22% of physically abused children, 5% of sexually

References (6)

  • M. Andronicus et al.

    Non-accidental burns in children

    Burns

    (1998)
  • R.P. Hummel et al.

    Outcome and socioeconomic aspects of suspected child abuse scald burns

    J. Burn Care Rehab.

    (1993)
  • B.M. Renz et al.

    Child abuse by scalding

    J. Med. Assoc. Georgia

    (1992)
There are more references available in the full text version of this article.

Cited by (0)

View full text