"Excessive diagnosis"

My four year old had woken with a hot, red, swollen ear (at least four times its original size). Apart from the swelling to my child’s ear and gland directly below the ear, there were no other issues-no pain, no fever, no itchiness, no discomfort, and eating was normal and playing was normal.

We had spent the previous day gardening and I assumed it had been bite by something or had a reaction to a plant. I administered an antihistamine and took my child to a pharmacy to double check. The pharmacist was quite alarmed and suggested I get to a Dr or the ED if the antihistamine had no affect after about an hour.

I phoned the afterhours clinic in the morning and was told to call back when they re-opened in the afternoon and I would be able to see someone after 5pm so I called the ED in the hope to find out the rough waiting time-I didn’t want to spend three or four hours waiting in ED when I could get to the clinic in six hours. The ED put me through the nurse on call hotline-they informed me if there were no signs of pain, fever, problems swallowing/eating or any balance issues then I would be fine to wait to get into the clinic. I phoned the clinic when it opened and got an appointment shortly after.

When we arrived at the afterhours clinic the admin staff we saw were amazing and so friendly and welcoming to both me and my child. The receptionist spoke to my child, showed what she was doing and made my child feel so comfortable in a new environment.

We waited 40min and then went into the doctor, who was very friendly, introduced themself and asked what was wrong. After my explanation the doctor took my child’s temperature, it was normal. The doctor looked in the ears and said the swollen one looked slightly red. The doctor felt behind the ear and asked if there was any pain, my child answered that it hurt a little bit, but did not once wince or move head away from the Dr, like I would suspect a child to if they felt pain.

The Dr then seemed to quickly diagnosed the illness as mastoiditis and explained the infection to me and I questioned that there hadn’t been any accompanying fever or pain. The doctor said that they don’t always appear as a symptom and prescribed antibiotics but also requested I visit my own Dr the next day. I found this to be an odd request.

If the doctor diagnosed my child with an infection, prescribed antibiotics then why would I need to see my own Dr the next day? I would understand if the after-hours doctor said to visit my own Dr if the infection got worse, but it seemed like they were seeking a second opinion.

I did a bit of research into mastoiditis. From what I could tell my child had no symptoms of this infection other than a swollen ear.

I administered the antibiotics as directed and booked an appointment the following morning with our regular Dr. She thoroughly checked my child out and said it was definitely not mastoiditis. I was told it was more likely to be a mild reaction to a bite, sting or plant allergy. At that point the ear had reduced in swelling somewhat, but it was still over twice its normal size. She said as the swelling had reduced she was unsure if it were the antibiotics or the antihistamine that had treated the problem so I was to continue the antibiotics for the full course and give one more dose of antihistamines.

I left feeling relieved but somewhat annoyed at what I perceived to be an excessive diagnosis the afterhours doctor had given us and perhaps the course of unnecessary antibiotics, however, I came to the conclusion that I would prefer an ‘over diagnosis’ to an ‘under diagnosis’ any day. I would far prefer a diagnosis of mastoiditis for a mild allergic reaction than a diagnosis a mild allergic reaction for mastoiditis.

Please don’t read this as a complaint in anyway. I was happy with our treatment at the after hours clinic, however I did want to provide you with this feedback. I appreciate the opportunity to be able to attend an afterhour’s clinic rather than to clog up the ED and spend, what could have been hours waiting for not so serious issues, so thank you!