{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T21:25:58Z","timestamp":1776461158691,"version":"3.51.2"},"reference-count":21,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Munchausen syndrome by proxy (MSBP) or factitious disorder imposed on another (FDIA) is a bizarre psychiatric entity, consisting of the fabrication of symptoms and alteration of laboratory tests by a caregiver. It is considered a serious form of child abuse. Alarm signs are frequent medical visits and strange symptoms that are never objectified during hospitalization. Methods: This case sets a bright light on how difficult the diagnosis and management of FDIA is and the severe consequences this disease has on a defenseless child. Results (Case report): A boy who is 3 years 8 months old first presented to our department in October 2022 for prolonged fever. We ruled out infections, malignancies, and autoimmune diseases. The patient kept coming back once every fortnight for the same reason\u2014fever, every time associating it with something in particular and new\u2014from painful joints to hemorrhagic complaints. Interestingly, with every new visit, the patient\u2019s medical history became more complex. The mother also developed an attachment relationship with the medical staff. During a 4-month period of repeated admissions, the child\u2019s symptoms were never objectified throughout hospitalization, and never consistent with the declared symptoms and test results. When the physician\u2019s attitude changed from empathic to distant, she never came back for check-ups. Conclusions: A pediatrician\u2019s work largely depends on good communication with the parents. When there is no medical explanation for declared symptoms, one might question the merit of the story.<\/jats:p>","DOI":"10.3390\/children11121482","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:47:22Z","timestamp":1733287642000},"page":"1482","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Where Reality and Fantasy Collide\u2014Prolonged Fever to Munchausen Syndrome by Proxy"],"prefix":"10.3390","volume":"11","author":[{"given":"Raluca Maria","family":"Vlad","sequence":"first","affiliation":[{"name":"Department of Paediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cGrigore Alexandrescu\u201d Emergency Children\u2019s Hospital, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruxandra","family":"Dobritoiu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cGrigore Alexandrescu\u201d Emergency Children\u2019s Hospital, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Turenschi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Ploiesti Children\u2019s Hospital, 100336 Ploie\u0219ti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8604-8691","authenticated-orcid":false,"given":"Daniela","family":"Pacurar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cGrigore Alexandrescu\u201d Emergency Children\u2019s Hospital, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"ref_1","unstructured":"(2024, August 23). 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