The Diagnosis Secret

If your little girl has a stuffy nose, a slight fever, and wakes up crying, tugging on her ear, and saying, “My ear hurts!” – then she may have an acute ear infection. But it is almost as likely that she has a cold virus, with ear pain from pressure in the ear, and no acute bacterial infection at all.

She may need earache relief, not ear infection treatment. Ear infections cannot be accurately diagnosed just based on the story, either by good doctors or by good parents. Physical evidence is needed to confirm the diagnosis. So, when was the last time you heard your doctor say, after looking into your child’s ears, “I think your child has an acute ear infection, but I’m not sure either way.”? If you’ve heard this, you may have a great doctor! As parents, we want our doctors to be accurate diagnosticians, certain of their findings. The secret truth is that the diagnosis of ear infections is often uncertain. An eardrum might be red just from crying. Even in the best of hands, uncertain diagnoses happen every day – and we would all be better served if we respected doctors’ honesty in this regard. An uncertain ear infection should be handled differently than one that is clear-cut. I applaud the 2004 AAP/AAFP guidelines for creating a treatment category for uncertain ear infections.

Follow the links below to read the entire story.
Revolution in Ear Infection Treatment
Focus on Pain
The Antibiotic Hoax
The Diagnosis Secret
One Thing is Certain
Vanilla Ear Infections/Red Hot Infections
Who Should Get Antibiotics?
What Does Observe Mean?
The Bottom Line: How well Does Observation Work?

Published on: March 11, 2004
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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