A case of pneumonia in childhood suspected to suffer child abuse

A 3-year-old boy entered the emergency room with cardiopulmonary arrest. Although roentgenograms showed well-defined pneumonia, his death was reported to the police because of multiple bruises on the body surface. The autopsy revealed that his death was caused not by trauma but by the disease, i.e., bronchopneumonia. However, there seemed to be some discrepancy between the explanation by his stepmother and the findings of injuries. Mother alleged that he seemed to be well prior to death, but we think he should have suffered from various symptoms due to pneumonia up to two or three days before death. He was not a malnourished child, but he might be classified as a variant of neglect. We failed to show causal relationship between the cause of death and the victim's injuries, but his death might have been indirectly correlated with child abuse.