First Report of “Munchausen Syndrome by Proxy Variant” in an Injection Drug User with 12 New Organisms in Blood Cultures 17 Days after Admission to the Hospital

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Excellent

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments:

The subheading “Take Home Points” should be replaced with “Conclusion”.

The case description is adequate with well supported data. The Discussion states clearly that the presence of multiple environmental and skin microbes in blood cultures is suggestive of deliberate injection of contaminated material therefore making the case a variant of Munchausen syndrome by proxy. The conclusion is apt in stating that the materials brought by visitors to hospital rooms of drug addicts must be screened and new onset of unexpected symptoms should alert caregivers of the possibility of such abuse.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Writing style

Q: Is it clear and understandable?

A: Good

Further comments on the paper

Comments: This case study presents the first report of “Munchausen Syndrome by Proxy Variant” in an injection drug user with 12 new organisms in blood cultures, 17 days after admission to the hospital. The term Munchausen syndrome by proxy is when a person fabricates an illness on behalf of another. The injection drug user was admitted to the hospital for a spinal epidural abscess which was drained, treated with antibiotics and the patient was doing well, suddenly becoming very sick and febrile on day 17. Twelve new organisms in blood cultures of a hospitalized patient many days after admission has never been reported earlier.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team