Sexual Abuse in Munchausen Syndrome by Proxy: Part 4 – Medical Sexual Abuse Red Flags

In my previous posts in this series, I reviewed two articles, one from 1989 and one from 1999, that describe medical sexual abuse in MSbP perpetrators. In the cases reviewed, 5 perpetrators were mothers and one was a father.

Two red flags that medical sexual abuse by an MSbP perpetrator is going on are

  1. False sexual abuse accusations by the perpetrator about others, and
  2. Polymicrobial bacteremia and sepsis in the victim.

Both topics have multiple articles about them; I will describe only two representative ones here.

Article 1 – False Accusations: Woman Shops Baby Around to Sheriffs

In this article, a divorced MSbP mom shops her male baby around to different sheriffs’ offices trying to get them to do a rape kit on him because she insists the estranged father is doing absolutely crazy things to sexually abuse this kid.

She reports finding urine, feces and semen all over the place. She announced to the community about all these crazy sexual acts her ex is apparently doing, but no one could find any evidence.

Next, when sheriffs’ offices caught on, they started refusing to take her case. She started then going over to other towns. Each time she convinced a sheriff, they would do a rape kit on the baby. She coached the baby and now she and the baby were saying the same lies about the father.

Sheriff Patch from LA County

One day, when no sheriff would cooperate in all the different towns, she went to a woman’s shelter complaining profusely about the abuse. By now, she had organized women’s agencies to be involved in this high-profile case. Workers at the shelter observed the woman spent more time on the phone with these agencies than with her baby.

The story stops here. She apparently goes to court – I guess as the prosecutor – but no one rescues the baby. No one talks about the sexual abuse the baby is enduring, either. I guess this one didn’t get counseling.

Article 2 – Polymicrobial Bacteremia and Medical Sexual Abuse

“Polymicrobial bacteremia” is medicalese that, in this case, can be loosely translated to “this kid is dying because her blood is swimming with bacteria from so many different microbes it’s impossible to tell where they came from”.

Bacteremia isn’t that unusual. If a kid is suffering from an overwhelming infection, the kid can die of bacteremia, especially if the infection is antibiotic-resistant. When a person is overcome with bacteria and is going to die if it’s not fixed, it’s called “sepsis”, and the person is said to be “septic”. It is very easy for someone to die if sepsis is induced and not treated immediately.

Plate from MTT assay

But bacteremia leading to sepsis in kids is generally not “polymicrobial” – it would be a single known microbe that wasn’t being killed. So this smart guy named Jacob Amir in 1989 wrote a letter to the editor of American Journal of Diseases in Children in response to an article someone else had published about what might be the cause of polymicrobial bacteremia in children. Amir underscored the fact that the authors totally missed the MSbP angle.

Amir points out, “Adult-induced sepsis in children has been described in several reports as a manifestation of Munchausen syndrome by proxy.” Amir points out that this happens by the MSbP mom through “deliberate injection of bacteriologically contaminated material”.

Although the authors of this work do not describe a route through the genitals to introduce this material, other papers show that this is one way this happens. MSbP moms tend to prefer using their oral, feces or vaginal discharge to contaminate lines placed in the child inpatient, and may actually add these contaminants to their fingers as part of inducing sepsis.

Red Flags for Medical Sexual Abuse: False Accusations and Polymicrobial Bacteremia

In summary, two red flags for medical sexual abuse are:

  1. the abuser making repeated false accusations about others as sexual abusers, and
  2. polymicrobial bacteremia.

If you are a healthcare provider or work with children in another capacity, if you see either of these red flags, you should rescue the child the way you would any child being raped repeatedly. Realize that if you allow the child to spend any time with the perpetrator, the child may be murdered, because sepsis kills.

My next post in this series will explain the potential motives for MSbP perpetrators doing medical sexual abuse.

Want to read more on polymicrobial bacteremia in MSbP victims?

Here is a recent one, from 2007.

Images courtesy of the State of California and Shinryuu.


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