RESUMO
The medical records and computed tomography (CT) scans of all children less than 1 year of age admitted to the hospital with head injury over a 2-year period were reviewed. Sixty-four percent of all head injuries, excluding uncomplicated skull fracture, and 95% of serious intracranial injuries were the result of child abuse. The occurrence of intracranial injury in infants, in the absence of a history of significant accidental trauma, such as a motor vehicle accident, constitutes grounds for an official child abuse investigation.
Assuntos
Acidentes , Maus-Tratos Infantis , Traumatismos Craniocerebrais/etiologia , Acidentes de Trânsito , Concussão Encefálica/etiologia , Lesões Encefálicas/etiologia , Hemorragia Cerebral/etiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Crânio/lesões , Fraturas Cranianas/etiologiaRESUMO
Forty-six children less than 12 years of age with gonorrhea were studied over a 4 1/2-year period. The investigation was conducted by a multidisciplinary team including physicians, social workers, and health department representatives. Extensive interviewing and routine culturing of contacts eventually identified the source of gonorrhea in 38/46 (83%) children. Males, both adult and preadolescent, were implicated as the source of gonorrhea almost twice as often as the child's mother. Nineteen children were victims of sexual assault, but only four of them had a hymenal orifice larger than one fingerbreadth. Compliance, both in pursuing the history and obtaining cultures of contacts, was significantly increased by admission to the hospital. A Gram stain and culture for gonorrhea should be done in all children presenting with vaginal discharge regardless of history. Hospitalization of children with suspected gonorrhea greatly facilitates the contact identification.
