In my first year as a RN (late 1980’s/early 1990’s), I took care of a toddler (Alexis) who had frequent admissions for various abdominal complaints. She had major work ups, and they couldn’t find a diagnosis, but IIRC, her nutritional status was poor. She ended up with a Broviac (long term IV catheter inserted into a large vein in the chest or neck) and placed on TPN (IV “feedings”).
On her last admission, she had overwhelming sepsis (infections in her blood). Usually, sepsis is one single organism (usually bacteria, but could be other microorganisms such as a fungus). Her blood cultures grew out a fungus (not uncommon with TPN) and 4 bacteria which are rarely seen, except in aquarium water. The docs theorized after her death that the mother injected fish tank water into her Broviac, which caused the sepsis. Most likely Munchausen by Proxy, but never proven (it’s very difficult to prove from a legal standpoint).