Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit
The objective: to establish the reasons of discrepancy between the preliminary and final clinical diagnoses in patients admitted to TB inpatient unit, to determine ways to improve the diagnosis of tuberculosis at the pre-hospital stage.Subjects and Methods. We studied 130 medical records of patients...
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New Terra Publishing House
2023-03-01
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| Series: | Туберкулез и болезни лёгких |
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| Online Access: | https://www.tibl-journal.com/jour/article/view/1709 |
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| author | E. V. Korzh N. A. Podchos A. F. Zavgorodniy |
| author_facet | E. V. Korzh N. A. Podchos A. F. Zavgorodniy |
| author_sort | E. V. Korzh |
| collection | DOAJ |
| description | The objective: to establish the reasons of discrepancy between the preliminary and final clinical diagnoses in patients admitted to TB inpatient unit, to determine ways to improve the diagnosis of tuberculosis at the pre-hospital stage.Subjects and Methods. We studied 130 medical records of patients (77 HIV negative patients - Group 1, 53 HIV positive patients – Group 2) admitted to the inpatient unit of TB hospital in 2014-2022, in whom tuberculosis (TB) was excluded after examination.Results. In Group 1, all patients were preliminary diagnosed with pulmonary tuberculosis, in Group 2, 29 patients were preliminary diagnosed with pulmonary tuberculosis and 24 patients - with tuberculous meningitis (TM). Primary examination and analysis of medical records caused doubts about the diagnosis of 60 (77.9%) patients in Group 1, and 40 (75.5%) patients in Group 2. When pulmonary tuberculosis was suspected, pneumonia and cancer were most often verified: 33.8% and 27.3% in Group 1, 51.7% and 24.1% in Group 2, the causes of diagnostic errors at the pre-hospital stage included insufficient attention to medical history and clinical manifestations; outcomes of treatment with broad-spectrum antibiotics were ignored; no control radiological examination was performed; diagnostic fibrobronchoscopy, chest computed tomography, consultations of medical specialists were not provided. Often HIV negative individuals 25/47 (53.2%) had false positive results of sputum microscopy. In Group 2, in 24 patients with suspected tuberculous meningitis, the final diagnosis was cerebral toxoplasmosis (41.7%) and mycotic meningitis (25.0%). Poor coverage with neuroimaging, genetic molecular and serological tests led to diagnostic errors. |
| format | Article |
| id | doaj-art-dd80b6bf44d340cdaa1d5bccb0921bce |
| institution | OA Journals |
| issn | 2075-1230 2542-1506 |
| language | Russian |
| publishDate | 2023-03-01 |
| publisher | New Terra Publishing House |
| record_format | Article |
| series | Туберкулез и болезни лёгких |
| spelling | doaj-art-dd80b6bf44d340cdaa1d5bccb0921bce2025-08-20T01:47:41ZrusNew Terra Publishing HouseТуберкулез и болезни лёгких2075-12302542-15062023-03-011011556210.58838/2075-1230-2023-101-1-55-621704Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB UnitE. V. Korzh0N. A. Podchos1A. F. Zavgorodniy2M. Gorky Donetsky National Medical University; Republican Clinical TB Hospital, Ministry of Health of Donetsk National RepublicRepublican Clinical TB Hospital, Ministry of Health of Donetsk National RepublicRepublican Clinical TB Hospital, Ministry of Health of Donetsk National RepublicThe objective: to establish the reasons of discrepancy between the preliminary and final clinical diagnoses in patients admitted to TB inpatient unit, to determine ways to improve the diagnosis of tuberculosis at the pre-hospital stage.Subjects and Methods. We studied 130 medical records of patients (77 HIV negative patients - Group 1, 53 HIV positive patients – Group 2) admitted to the inpatient unit of TB hospital in 2014-2022, in whom tuberculosis (TB) was excluded after examination.Results. In Group 1, all patients were preliminary diagnosed with pulmonary tuberculosis, in Group 2, 29 patients were preliminary diagnosed with pulmonary tuberculosis and 24 patients - with tuberculous meningitis (TM). Primary examination and analysis of medical records caused doubts about the diagnosis of 60 (77.9%) patients in Group 1, and 40 (75.5%) patients in Group 2. When pulmonary tuberculosis was suspected, pneumonia and cancer were most often verified: 33.8% and 27.3% in Group 1, 51.7% and 24.1% in Group 2, the causes of diagnostic errors at the pre-hospital stage included insufficient attention to medical history and clinical manifestations; outcomes of treatment with broad-spectrum antibiotics were ignored; no control radiological examination was performed; diagnostic fibrobronchoscopy, chest computed tomography, consultations of medical specialists were not provided. Often HIV negative individuals 25/47 (53.2%) had false positive results of sputum microscopy. In Group 2, in 24 patients with suspected tuberculous meningitis, the final diagnosis was cerebral toxoplasmosis (41.7%) and mycotic meningitis (25.0%). Poor coverage with neuroimaging, genetic molecular and serological tests led to diagnostic errors.https://www.tibl-journal.com/jour/article/view/1709overdiagnosis of tuberculosispre-hospital stagetb unit |
| spellingShingle | E. V. Korzh N. A. Podchos A. F. Zavgorodniy Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit Туберкулез и болезни лёгких overdiagnosis of tuberculosis pre-hospital stage tb unit |
| title | Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit |
| title_full | Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit |
| title_fullStr | Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit |
| title_full_unstemmed | Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit |
| title_short | Overdiagnosis of Tuberculosis in Patients Referred for Hospitalization to TB Unit |
| title_sort | overdiagnosis of tuberculosis in patients referred for hospitalization to tb unit |
| topic | overdiagnosis of tuberculosis pre-hospital stage tb unit |
| url | https://www.tibl-journal.com/jour/article/view/1709 |
| work_keys_str_mv | AT evkorzh overdiagnosisoftuberculosisinpatientsreferredforhospitalizationtotbunit AT napodchos overdiagnosisoftuberculosisinpatientsreferredforhospitalizationtotbunit AT afzavgorodniy overdiagnosisoftuberculosisinpatientsreferredforhospitalizationtotbunit |