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"Diagnosis concerns"

About: Broome Health Campus / Emergency Department

(as a parent/guardian),

I am writing to raise awareness for a misdiagnosis of my toddler in the hopes that further education can be done to prevent this happening to a child in future. Our child had what appeared to be the start of a rash spreading on their face, the Doctor very quickly diagnosed this as ezcema and advised to treat with steroid cream which was provided at the time. In my opinion the rash did not look like ezcema as our child does suffer from this from time to time and there was some mild evidence of this on their legs which looked very different to the spots on their face.

Having trusted the drs diagnosis while I was at work my partner applied the steroid which after only one use severally exacerbated the rash, requiring another visit to our GP  where the rash had tripled in size on my toddler's face, swabs were taken but still no cause was confirmed.

The rash eventually developed into a staph infection so it is unknown what was the original cause but the steroid use exacerbated the original rash and I feel was too quickly diagnosed and ruled out as anything further and treated correctly. In hindsight I should have been at the appointment but my partner trusted the Doctors diagnosis, hopefully in future a rash on a young child's face should have been reviewed by a second Doctor if the first Doctor was unsure of the cause.  I appreciate Doctors can make mistakes but treating with steroid cream on such a young child has had severe consequences. 

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Responses

Response from David Woodward, Acting Senior Medical Officer, Broome Hospital, WA Country Health Service about a year and a half ago
David Woodward
Acting Senior Medical Officer, Broome Hospital,
WA Country Health Service

Doctor at Broome Hospital

Submitted on 15/11/2022 at 11:50 AM
Published on Care Opinion at 12:17 PM


Dear couragerh34,

Thank you for taking the time to highlight your concerns around diagnosis and treatment of your child’s facial rash.

It is true, some rashes are made worse by steroids. But some genuinely do require a steroid treatment.

It can be hard to differentiate but overall one should be cautious with prescribing steroids for facial rashes in children and, if deemed necessary, safety net with only using milder steroid creams in the first instance and for the shortest duration possible.

I also agree that any diagnostic uncertainty should have resulted in a second opinion.

It’s hard to discuss specifics without more information.

My name is David Woodward and I am the Acting Senior Medical Officer for Broome Hospital.

I would be happy to look into this case further and ascertain whether we needed to do anything differently/provide feedback to the practitioner involved.

Feel free to contact me on 0419196947 or david.woodward@health.wa.gov.au

Regards

Dave Woodward

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