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The GP of a 15-year-old girl who died of TB has told her inquest that he "fully accepts" that a diagnosis of the disease "never crossed his mind" even though she had tested positive for it before.
Alina Sarag, from Birmingham, became ill in August 2010 after returning from a holiday in Pakistan.
She had been treated for tuberculosis in 2009, after an outbreak at her school and it was found to be "latent" in her.
But over nearly five months, Alina's father Sultan said, her condition deteriorated. She was being sick up to 10 times a day, she could not walk unaided, and she became emaciated and could only eat baby food.
Before she died after a cardiac arrest in January 2011, she had had 23 GP consultations, and her family had sought help at four hospitals.
Mr Sarag claimed he had called Dr Sharad Pandit's surgery for help "more than 50 times".
Doctors considered that she could have meningitis or bulimia, but TB was never considered as a diagnosis.
Dr Pandit said Miss Sarag's symptoms had not suggested she had TB and that it was never mentioned to him that she was also suffering from coughs, night sweats and fever.
He also said that she never had to be carried into his surgery because she was so ill.
He said that he had wondered if she had a "psychological problem", while exploring other options, but that he never mentioned it in front of her and he never suggested that she should see a spiritual healer.
Mr Sarag had told the court earlier this week that the GP had suggested Alina's illness was "all in her head" and she might be "love sick" for a boy she had met in Pakistan.
The inquest continues.
