Fever of unknown origin caused by child abuse; A case report
DOI:
https://doi.org/10.22122/cdj.v5i1.227Keywords:
Fever, Pyrexia, Child, Child Abuse, Child NeglectAbstract
BACKGROUND: Fever is the most common complaint in children. Some children frequently refer to treatment centers for long periods of continuous fever; and despite precise assessments, the cause of the fever is unknown. Since there is no evidence of relationship between fever of unknown origin (FUO) and child abuse, we report a case of fever of unknown origin case caused by child abuse.
CASE REPORT: An 8-year-old boy was referred to a pediatric ward of Mehr hospital in Malayer City, west of Hamadan Province, Iran, followed by a fever of unknown origin to assess the disease. The patient repeatedly had severe fever twice a month, since he was seven years old. He did not presented to hospital due to normalization for his family. He then returned to the hospital with repetition of fever and not responding to the medications used at home. After a few days of admission to the hospital and performing examinations and laboratory procedures and pictograph, there was no finding to determine the cause of the fever. However, in the interview, child's mother secretly expresses child abuse and her harassment with the concern and fear of the child's father.
CONCLUSION: Cultural beliefs and parental power are two phenomena that prevent the use of appropriate tools for understanding stresses and bitter experiences of childhood. For these reasons, history taking and physical examination by doctors and nurses in the hospital are limited only to the physical examinations. Therefore, there is a need for laws and strong supporters who can support doctors and nurses to report child abuse.
References
Chusid MJ. Fever of unknown origin in childhood. Pediatr Clin North Am 2017; 64(1): 205-30.
Palazzi DL. Fever of unknown origin in children: Evaluation [Online]. [cited 2017]; Available from: URL: https://www.uptodate.com/contents/fever-of-unknown-origin-in-children-evaluation
Sachs-Ericsson N, Medley AN, Kendall-Tackett K, Taylor J. Childhood Abuse and Current Health Problems among Older Adults: The Mediating Role of Self-Efficacy. Psychol Violence 2011; 1(2): 106-20.
University of Rochester Medical Center. Children under stress develop more fevers [Online]. [cited 2007 Mar. 7]; Available from: URL:
https://www.sciencedaily.com/releases/2007/03/070305202905.htm
Soleymani-Fard F, Khademol-Hoseyni SM. The Unknown fever and stress. Educative Journal of School of Nursing of Baqiyatallah University of Medical Sciences 2014; 15(56): 19-26. [In Persian].
Ribeiro CS, Rodrigues F, Ribeiro C, Magalhaes T. A case report for differential diagnosis: Integrative medicine vs child abuse. Leg Med (Tokyo) 2010;
(6): 316-9.
Oka T. Psychogenic fever: how psychological stress affects body temperature in the clinical population. Temperature (Austin) 2015; 2(3): 368-78.
Olivier B. Psychogenic fever, functional fever, or psychogenic hyperthermia? Temperature (Austin) 2015; 2(3): 324-5.
Handwerker WP. Child abuse and the balance of power in parental relationships: An evolved domain-independent mental mechanism that accounts for behavioral variation. Am J Hum Biol 2001; 13(5): 679-89.
Moylan CA, Herrenkohl TI, Sousa C, Tajima EA, Herrenkohl RC, Russo MJ. The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. J Fam Violence 2010; 25(1): 53-63.
Runyan D, Wattam C, Ikeda R, Hassan F, Ramiro L. Child abuse and neglect by parents and other caregivers. Geneva, Switzerland: World Health Organization; 2002.