Munchausen syndrome by adult proxy revisited.

A new variant of Munchausen Syndrome by Proxy (MSbP) case is presented here: Munchausen by Adult Proxy (MSbAP). The article discusses the case of a man (publicly known as the "Gasoline Injector") who is serving a 46-year jail term for attempted murder and manslaughter. His behavior is reminiscent of MSbP but his victims were two female adults, and his cell mate (on whom he repeated his actions). A description is given in terms of egosyntonic irresistible pathological impulses involving sexual objects. A common ground is proposed for paraphilias, Munchausen syndrome, MSbP and MSbAP.