Cautionary tales - Dr Miriam Grotowski

A MOTHER brought her 10-year-old daughter to see a colleague in our regional practice reporting tiredness, lethargy and snoring.

History revealed no temperatures or sweats, arthralgia or arthritis. There was no history of upper respiratory tract infections, no gastrointestinal symptoms other than constipation and a normal appetite.

The symptoms had been present for at least six months. She was fully immunised, and there was no significant neonatal or past surgical or medical history. No one else in the family had been unwell or travelled outside Australia.
Specifically there were no obvious family issues or observable anxiety or depression.

Tests for Ross River and Barmah Forest, Epstein-Barr virus and a full blood count were normal and the family was reassured, however they returned some two months later with concerns about the lethargy.

A referral to an ENT surgeon was made who felt the tonsils/adenoids were not significantly