我们报告了Munchausen综合征代理(MSBP)病例,表现为咽部吞咽困难和获得性气管食管瘘(TEF)。一名六个月大的沙特男性发烧,持续性口腔溃疡,溃疡的间歇性出血,未能茁壮成长(FTT),食欲不振,和可能的遗传病。他有因感染反复入院的病史,包括那些影响胸部的,耳朵,和肠。此外,他检测出万古霉素耐药肠球菌呈阳性。无手术或输血史。由于病人的营养状况,插入了胃造口管。尽管凝血和血小板分布正常,但患者在住院期间气管造口管复发性出血。因此,诊断喉镜检查后,耳鼻喉科专家指出,这种咽后损伤见于受伤的患者,也就是说,在这种情况下,由母亲引起的,因为在反复出血期间,她是唯一一个带着孩子的人。因此,我们描述了MSBP的临床实例,尤其是模仿咽部吞咽困难,导致延迟诊断。我们建议在遇到咽部吞咽困难和口腔溃疡时,将MSBP添加到可能的诊断中。
We report a Munchausen syndrome by proxy (MSBP) case, which presented as pharyngeal dysphagia and an acquired tracheoesophageal fistula (TEF). A six-month-old Saudi male presented with fever, persistent oral ulcers, intermittent bleeding from the ulcers, failure to thrive (FTT), poor appetite, and possible genetic disease. He had a history of recurring admissions due to infections, including those affecting the chest, ear, and bowel. Additionally, he tested positive for vancomycin-resistant enterococcus. There was no history of surgical procedures or blood transfusions. Due to the patient\'s nutritional status, a gastrostomy tube was inserted. The patient had recurrent bleeding from the tracheostomy tube during the hospital stay despite normal coagulation and platelet profile. Consequently, after diagnostic laryngoscopy, the otolaryngologist specialist pointed out that such retropharyngeal injuries are seen in patients with inflicted injuries, which is, in this case, caused by the mother, as she was the only one with the child during the recurrent bleeding episodes. Thus, we describe a clinical instance of MSBP, especially imitating pharyngeal dysphagia, leading to a delayed diagnosis. We advise adding MSBP to the possible diagnoses upon encountering pharyngeal dysphagia and oral ulcers.