farmdoc's blog post number 527

My eldest darling granddaughter [EDG] is ill. She has been for a few days. With a rash (pictured), a fever, and malaise. And anxiety – because she’s usually well and active, but now she’s not. I was consulted early on – by phone and also digital image email attachment. When I was a medical student over 40 years ago, dermatology wasn’t taught at all well. So I’m not a dab hand at rashes. With an acute rash, as in this case, my strategic plan’s to first rule out a serious cause; and once that’s done, to treat it as skin manifestation of a general illness, to treat it accordingly, and to reassure the patient. Some rashes are pathognomonic, i.e. the rash’s features make diagnosis easy. But this one wasn’t. I thought EDG’s rash was most likely insect bites, or alternatively the rash of a non-specific viral illness. It’s hard enough to diagnose a rash in the same room let alone from 622 km away. So I began the above plan; and by phone twice a day I checked on progress. EDG’s mum – darling Kate – consulted a doctor at the local hospital who diagnosed a viral rash. Whew! My second horse had come home; though my first’s still wandering free in someone’s back paddock. So far treatment has settled the itch, fever and anxiety. A bit. But the rash is unchanged. I expect full recovery by week’s end – thanks to Mother Nature, Father Time and EDG’s immune system. But with two schoolgirls and a childcare toddler in the family, the next medical help call to me is likely not too far in the future. I can hardly wait. For can there be a greater joy in life than helping one’s grandchildren? Don’t answer that – it’s a rhetorical question.