Munchausen syndrome by proxy complicating ear surgery

Munchausen syndrome by proxy (MSBP) is a form of child abuse in which a parent or caretaker produces or simulates illness in a child. Often great lengths are undertaken to diagnose and treat the myriad of symptoms and problems in these children. Unnecessary examinations, treatments, and hospitalizations ensue. Unfortunately, some victims of this syndrome die. Munchausen syndrome by proxy is a form of child abuse and should be reported appropriately. The diagnosis of MSBP is difficult to make and must be done with caution as the implications for those involved are serious. Therefore, care must be taken in properly identifying cases. We present a case of MSBP complicating the postoperative course of a boy after undergoing ear surgery for cholesteatoma. Characteristics and potential clues to the diagnosis of MSBP are discussed. The goal of our article is to inform otolaryngologists of this syndrome so they may develop a high index of suspicion to better detect its occurrence.