Factors Associated With Misdiagnosis of Smear-Negative Tuberculosis: An Experience in Taiwan.
BACKGROUND: A negative sputum smear from a patient with history, physical examination, and chest x-ray findings suggestive of tuberculosis (TB) presents a diagnostic dilemma. We investigated the possible factors associated with a misdiagnosis and inappropriate treatment of TB among such patients. ME...
| Publicado en: | Respiratory Care Vol. 57; no. 5; pp. 753 - 758 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
May2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104555603&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104555603 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: May2012 vid: 57 iid: 5 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 104555603 74485994 10.4187/respcare.01454 NLM22152195 104555603 ppf: 753 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Factors Associated With Misdiagnosis of Smear-Negative Tuberculosis: An Experience in Taiwan. aug: au: Yang, Chih-Yun Guo, How-Ran Cheng, Ya-Yun Huang, Ruay-Ming affil: Department of Internal Medicine, Yongkang Veterans Hospital; Department of Occupational Safety and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan sug: subj: Tuberculosis Diagnosis Diagnostic Errors Risk Factors Diagnostic Errors Etiology False Negative Results Sputum Analysis Human Record Review Taiwan Radiography, Thoracic Mycobacterium Tuberculosis Analysis Odds Ratio Bacteriological Techniques Descriptive Statistics Adult Middle Age Aged Aged, 80 and Over Chi Square Test Fisher's Exact Test Logistic Regression Univariate Statistics Multivariate Analysis Confidence Intervals Data Analysis Software Retrospective Design Male Female Age Factors Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: BACKGROUND: A negative sputum smear from a patient with history, physical examination, and chest x-ray findings suggestive of tuberculosis (TB) presents a diagnostic dilemma. We investigated the possible factors associated with a misdiagnosis and inappropriate treatment of TB among such patients. METHODS: We reviewed the records of 193 patients whose diagnoses with TB included conflicting test results and were reported to the Taiwan Centers for Disease Control in 2004. When other conditions were found to underlie the initial abnormal chest x-ray finding, the diagnosis was revised. RESULTS: Mycobacterium tuberculosis was isolated from sputum samples in 72 of 193 patients (37%), nontuberculous mycobacteria from 4 (2%), and no bacteriologic evidence of M. tuberculosis from 117 (61%). The initial diagnosis of TB was revised for 26 (13.5%) patients. Patients with positive M. tuberculosis culture had a lower incidence of revised diagnoses (4.2%, P < .001) than those negative for mycobacterial culture (17.1%) and those with nontuberculous mycobacteria (75%). Chest cavitations in this study were not a significant predictor of revised diagnosis (odds ratio 0.30, P = .08). CONCLUSIONS: An incorrect diagnosis of TB despite a negative sputum smear result is more likely to be made for patients positive for nontuberculous mycobacteria culture and less likely for patients with positive M. tuberculosis culture. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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