Case reportBizarre paediatric facial burns
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
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Infants under 1 year of age have a significant risk of burn injury
2008, BurnsCitation Excerpt :Deliberately inflicted burns have been reported in the literature in as many as 1–26% of all children presenting at hospital with burns [22,23]. However, despite these reports, it has also been acknowledged that, it is often difficult to draw the line between accidental injury, neglect and deliberate abuse and this is particularly true of burns injuries [24,25]. Socio-economic factors, including lower income, limited education; limited maternal education and race have been associated with an increased risk of childhood burn injuries [2,26,27].
Staphylococcal scalded skin syndrome mimicking child abuse by burning
2007, Forensic Science InternationalCitation Excerpt :Burns and scalds represent 6–20% of all child abuse cases [1] and up to 26% of paediatric burn unit admissions are due to deliberately inflicted injuries [2,3]. Nevertheless, child abuse by burning is often under-recognized and under-reported, because of the difficulty of identifying non-accidental burns and scalds [4], and up to 50% of children undergo repeated abuse after they return home [1,5,6]. However, it must be emphasized that burns and scalds may be mimicked by medical conditions, such as bullous impetigo [7,8], phytophotodermatitis [9], contact dermatitis [10], and eczema [11], and a mistaken diagnosis and report of child abuse by burning has important consequences for the family and for the child itself.
The problem of acid violence in Bangladesh
2004, Journal of SurgeryA Systematic Review of Pediatric Nonaccidental Burns: Protecting the Children Through Knowledge, Vigilance, and Prevention.
2023, Annals of Plastic Surgery