Fabricated or Induced Illness

Author: Nial Mullen / Editor: Nicola McDonald / Reviewer: Muhammad Waseem, Peter Lynas / Codes: / Published: 26/04/2021

Fabricated or induced illness (FII) is a form of child abuse. It is associated with significant morbidity (physical and psychological) and mortality. Recognition of FII is frequently difficult and subsequent management is complex.

After completing this session you will be able to:

  • State the key features of FII
  • Describe the potential harm caused by FII
  • Recognise possible presenting features of FII
  • Plan the initial management of potential FII in the emergency department (ED)
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References

  1. Royal College of Paediatrics and Child Health. Child Protection. RCPCH, 2007. View document
  2. Royal College of Paediatrics and Child Health. Fabricated or Induced Illness by Carers (FII): A Practical Guide for Paediatricians. RCPCH, 2009. (Page 22, Table 3) View document
  3. Royal College of Paediatrics and Child Health. Perplexing Presentations (PP)/Fabricated or Induced Illness (FII) in Children Guidance. RCPCH, 2021. View document.
  4. McClure RJ, Davis PM, Meadow SR et al. Epidemiology of Munchausen Syndrome by Proxy, non accidental poisoning and non accidental suffocation. Arch Dis Child 1996;75:57-61. View article
  5. Meadow R. Munchausen syndrome by proxy. The hinterland of child abuse. Lancet 1997;2(8033):343-345. View abstract
  6. Coulthard MG, Haycock GB. Distinguishing between salt poisoning and hypernatraemic dehydration in children. BMJ 2003;326:157-160. View article
  7. Davis P, McClure RJ, Rolfe K et al. Procedures, placement and risks of further abuse after Munchausen Syndrome by Proxy, non accidental poisoning and non-accidental suffocation. Arch Dis Child 1998;78(3):217-221. View article
  8. Shabde N. Craft AW. Covert video surveillance: an important investigative tool or a breach of trust? Arch Dis Child 1999;81:291-294. View article
  9. Maguire S, Mann MK, Sibert J et al. Are there patterns of bruising in childhood which are diagnostic or suggestive of abuse? A systematic review. Arch Dis Child 2005;90(2):182-186 View article
  10. Maguire S, Mann MK, Sibert J et al. Can you age bruises accurately in children? A systematic review? Arch Dis Child 2005;90(2):187-189. View article
  11. National Institute for Health and Care Excellence. Urinary tract infection in children: Diagnosis, treatment and long-term management. NICE: CG54, 2007. View guideline

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