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Rib Fractures in an Infant: Incidental and Innocuous?

This 6-month-old turned up in the emergency department with cough and fever. As a preemie, she had required lung ventilation and received CPR, according to her parents. Rib fractures were discovered, of which they claimed no knowledge. Suspicious?

A 6-month-old girl was brought to the emergency department (ED) of a rural hospital by her mother and father. She had fever, cough, and irritability.

The child was born prematurely at 34 weeks; she had a long complicated stay in the newborn intensive care unit (NICU). She had required ventilation for several weeks and the parents were certain she had been given “fluid pills” (furosemide) because of lung “problems.”

When later questioned, the parents also stated that the child had received CPR on 2 occasions during her stay in the NICU.

Do the signs point to iatrogenic injury, or child abuse?

For the answer, read the complete case study.