Cases series of child abuse needing pediatric intensive care: Hiding in plain sight?

Child maltreatment may be in the form of physical, sexual, or emotional abuse or neglect. We present a case series of nine children needing pediatric intensive care unit care due to maltreatment. The children ranged in age from 6 weeks to 7 years. There were 6 boys. Three children were admitted for poisoning (filicide-suicide), four children with traumatic/hypoxic brain injury, one child with burns, and 1 with gunshot injury. Five children died, and one child survived with severe sequelae. In addition, a sibling and three mothers died at other hospitals. One child with poor outcome had a history of admission for similar complaints 2 weeks earlier. A history of family discord or domestic violence was obtained in six cases. There is a need for clinicians to be vigilant in detecting cases of maltreatment before irreparable harm to the child occurs.