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advanced practice nurses, critical care nursing, factitious illness by proxy, Munchausen syndrome by proxy [MSBP], nurse practitioners



  1. Lieder, Holly S. RN, MSN, CPNP-AC
  2. Irving, Sharon Y. RN, MSN, CRNP
  3. Mauricio, Rizalina RN, MSN, CPNP-AC
  4. Graf, Jeanine M. MD, FAAP


Munchausen syndrome by proxy is difficult to diagnose unless healthcare providers are astute to its clinical features and management. A case is presented to educate nurses and advanced practice nurses, of the nursing, medical, legal, and social complexities associated with Munchausen syndrome by proxy. This article also provides a brief review of the definition of Munchausen syndrome by proxy, its epidemiology, common features of the perpetrator, implications for healthcare personnel, and the legal and international ramifications of Munchausen syndrome by proxy.