|Eczema herpeticum-photo taken from open|
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A couple of weeks ago I saw a young mother who'd had symptoms of laryngitis for about 4 days. She was not especially unwell but by the next day she was in intensive care with an empyema needing emergency surgery to drain a chest abscess! At the end of a consultation for mild infectious disease, I generally say, "if you worsen (I try to specify in what way I mean-in terms of intensifying of symptoms, or new and unpleasant features, or just a non-specific, 'don't like how things are going') please do get back in touch". I caught myself saying it today, and since the reality is that in general practice one is nearly always seeing conditions at a very early stage of development, patient's need to know if, and when, they should report back.
I guess I've learnt from bitter experience that some patients will just accept a worsening situation simply because they have 'seen the doctor and he says I'm not too bad'. Always give simple, specific advice about follow up.