Failure to diagnose impetigo

Medical history

A young man presented to his GP with "spots" on one hand that had first appeared five days before. At examination, the GP made a provisional diagnosis of multiple warts, prescribed a salicylic acid paint to be applied twice daily, and arranged a referral to a dermatologist.

Two days later, after applying the medication as directed, the patient attended an A & E clinic. The spots were now enlarged, yellow and extremely painful. The doctor told the patient that the lesions had been misdiagnosed and were, in fact, impetigo.

One superficial abscess was incised and the infection treated with systemic antibiotics. Over the next week, the patient returned several times to have his wound dressed.

Negligence alleged

The GP received a letter of claim from the patient's solicitor. The solicitor asked for disclosure of the patient's medical records and offered the opinion of an expert dermatologist, who concluded that the GP had misdiagnosed the patient's condition. The patient's expert believed the development of ascending lymphangitis was, in part, caused by the inappropriate application of the prescribed medication, ie the salicylic acid paint. He also believed that the condition might have been cleared within a few days if the GP had prescribed a topical antibiotic or antiseptic cream.

Expert opinion

The MDU sought the advice of a GP expert. He pointed out that multiple warts were unlikely to have developed in less than a week and that their appearance differed markedly from impetigo. Advice from a dermatologist supported this view.

Outcome of claim

The patient accepted the sum of £2,500 as compensation for pain and loss of earnings.

This page was correct at publication on 13/04/2002. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.