Intentional poisoning of children--an overlooked category of child abuse: report of seven cases and review of the literature.

Seven instances of child abuse due to poisoning are reported; two of the children died. Forty-one cases of this form of poisoning are found in the literature. Of the total of 48 children, eight (17%) died as a result of the incident; and one was mentally retarded. The seven different agents described here are alcohol, glutethimide (Doriden), propoxyphene hydrochloride (Darvon), diazepam, insulin, lye, and pepper, constituting 27 different types of poison used by abusing guardians. The most common cause of abuse reported is excessive salt ingestion with water restriction. Excessive ingestion of water is the second most common cause. Barbiturates and tranquilizers are also frequent agents. In 30% of the cases, poisoning persists even after hospitalization. Child abuse by battering is associated in 20% of the cases. The need for a high index of suspicion of abuse in bizarre presentations of children for medical care when the etiology is obscure is emphasized.