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Factors Associated With Misdiagnosis of Smear-Negative Tuberculosis: An Experience in Taiwan.
- Source :
- Respiratory Care; May2012, Vol. 57 Issue 5, p753-757, 5p, 2 Charts
- Publication Year :
- 2012
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- TUBERCULOSIS diagnosis
AGE distribution
BACTERIOLOGY technique
CHEST X rays
CHI-squared test
CONFIDENCE intervals
DIAGNOSTIC errors
EPIDEMIOLOGY
FISHER exact test
MULTIVARIATE analysis
MYCOBACTERIUM tuberculosis
SPUTUM
STATISTICS
LOGISTIC regression analysis
DATA analysis
RETROSPECTIVE studies
DATA analysis software
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 00201324
- Volume :
- 57
- Issue :
- 5
- Database :
- Supplemental Index
- Journal :
- Respiratory Care
- Publication Type :
- Academic Journal
- Accession number :
- 74485994
- Full Text :
- https://doi.org/10.4187/respcare.01454