Child Abuse Leading to Blindness and deafness ( A Case Study)

Introduction: Child abuse is one of the major problems of today’s societies ;so in developed countries supportive laws for children have been established. Obvious manifestations of physical child abuse include: skin lesions (echymosis, erosion, biting), skull fractures and injury to the visceral organs. Physicians should take child abuse in their consideration whenever they encounter skin manifestations and skull fracture in an infant. In some societies the child abuse frequency is about 6 in 1000 infants which increases by aging.

Case Report: An 8 months old girl with convulsions since 1 day before admission was admitted in emergency room. Her past history was negative . Her mother had divorced . Physical examination, indicated that she was lethargic with no sign of fever. There were multiple skin lesions including bruising, lacerations, scratching, biting and burning on her head, trunk, body and extremities. Her anterior fontanel was bulged and funduscopy showed diffuse retinal hemorrhages. Investigations showed 25350/μlit degenerated RBCs in CSF, normal PT, PTT and platelets’ count. X-rays and brain CT scan showed that there were multiple skull fractures and brain edema which was confirmed by MRI . After two weeks a diffuse brain atrophy was reported in her follow up brain C-T scan.

Finally she became blind and lost her hearing ability . the abused child was returned to home( same previous situation) while anticonvulsant drugs were prescribed for her.

Conclusion: Encountering every infant with signs of afebrile convulsions, bulged fontanel, skin lesions, and retinal hemorrhages, one should think of child abuse as one of his differential diagnoses.