Posted by: linapk | 2009-09-09

what to do

Dear CS, I have a question and I have no one who can give me a straight answer. My daughter (1 year old) was in hospital 3 weeks ago and she developed this rash. The pediatrician said that it was exsema and gave cream to rub on.

It got worse and she was only better for 3 days then she got sick again. She was back in hospital on Sunday. Her rash has now covered her whole body and it is really bad and swollen and red and hot. You can' t touch her or hold her she is in that much pain.

I asked the Doc on Monday morning if it is not a allergy to the antibiotics as it looks a lot like my allergy spots but 100 x worse. He said that it is a reaction to her high fever and that it will go away.

Then on Tuesday he said that her blood tests indicated that she has a viral infection and that the rash is a result of this infection and that we cant do anything about it but let it run its course.

I have been really worried and emotional since she was admitted on Sunday and MOnday and tuesday was the worst because no one told me anythng until the doc came at 20H30 MOnday evening.

My daughter is also traumatized as they had to poke her full of holes as her veins keep falling flat when they try to put in a drip. Not to mention the rash, the fever, the pain and the constant arrray of nurses poking and prodding her.

Yesterday I asked for a second opinion as I did not think that it was a viral infection rash. I told the paediatrician this and he got annoyed with me, and said if i wanted a second opinion he will discharge her and i can take her to whoever I want.

I got upset as I told him I did not want a second opinion from another pediatrician but from a skin specialist as I did not feel that he was right about the infection. He said he did not doubt his diagnosis for one second, but if I insist, and if i am willing to pay for it, he will arrange for a skin specialist to come see her today.

The skin doc came this afternoon, looked at her and said it isn not a viral infection rash but a medicine allergy and that she is actually deadly sick. He rushed to the pediatricians office and I was told to wait for the pediatrician to come tell me what to do.

He came and told me what the skin doc confirmed, and then added that he did have a suspician that she might be having a allergic reaction to the meds but he did not voice his concern.

I am so upset at the moment and feel like I can beat the cr*p out of him.

I asked him several times if it was not a allergic reaction and he told me "no", and now she is in hospital not knowing when she will be released. I am 6 months pregnant with my second child and it kills me to see my child like that. She looks like she has serious herpes or something and he did not even say sorry.

What should I do, I feel like I want to tell him that he is an-|-who couldn't tell the difference between a rash and a allergy? HE is a pediatrician after all?

Sorry for the long email, I am venting a bit too I guess.

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Our expert says:
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It was entirely sensible to have asked for a second opinion. The oiginal diagnoses sound too vague and unhelpful to be useful.

It is absolutely the ethical DUTY of any doctor in that situation to help to arrange a second opinion, and NOT to take offense, let alone to threaten to discharge an obviously ill child.

I would seriously consider reporting such a doctor to the Health Professions Council in PRetoria for investigation and at least a warning about this bad behaviour.

A misdiagnosis of the sort you describe could be highly dangerous, and doctor's have to be very careful not to be so over-confident and to consider alternative diagnoses.

Sometimes it can be difficult to distinguish between one diagnosis and another, but this doesn't really sound like one of those situations, and one may need to keep 2 or more possible diagnoses in mind. If treating your first hunch isn't working, you need to think more seriously of your second hunch.

I entirely understand your anger, and in your place I would be furious. I wonder if your child can be placed under the care of the dermatologist rather than the over-dogmatic paediatrician ?

And if matters continue to be stormy clinically, I would seriously consider consulting a lawyer.

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