TUBERCULOSIS (TB) causes unnecessary deaths because of failure to diagnose and treat what is today a curable disease. A retrospective study was carried out in a general hospital to assess the magnitude of undiagnosed tuberculosis in hospitalized patients. Sixty-three cases of active tuberculosis, 39 of which were diagnosed only at autopsy, were found among 1306 autopsy cases during a three year study period. The reasons for the failure of diagnosis are discussed. For a correct diagnosis, the post-mortem examination must be systematic and include bacteriolo gical and histological studies.
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References
1.
Annual Department Report by the Director of Medical and Health Services, Hong Kong Government, 1987 -1988.
2.
Bobrowitz, I.D.Active tuberculosis undiagnosed until autopsy . Am J Med; 72: 650-658.
3.
Bryd, R.R. et al. Treatment of tuberculosis by the non-pulmonary physician. Ann Intern Med1977; 86: 799-802.
4.
Davis, P.D.O.Nunn, A.J., Byfield, S.P., Bhimji, N., Darbyshire, J., Fox, W., Citron, K.M.National Survey of tuberculosis notifications in England and Wales 1978-1979. Br Med J1980 ; 281 (6245): 895-898.
5.
S Enarson, D.A., Grzybwski, S., Dorken, E.Failure of diagnosis as a factor in tuberculosis mortality. Can Med Assoc J1978; 118: 1520-1522.
6.
Glassroth, J. , Robins, A.G., Snildw, D.E.Tuberculosis in the 1980s. N Eng J Med1980; 302 (26): 1441-1450.
7.
Goldman, K.P.Tuberculosis in hospital doctors. Tubercle1988; 69: 237-240.
8.
Huber, G.L., Millw, R.D.Training of Undergraduate Medical School Students in pulmonary disease: a regional analysis of New England Medical Schools. Chest1976; 70: 267-273.
9.
Katz, I., Rosenthal T., Michaeli, D.Undiagnosed tuberculosis in hospitalised patients. Chest1987; 6; 770-774.
10.
Kearns, T.J. , Russo, P.K.The control and eradication of tuberculosis . N Eng J Med1980; 303 (14): 812-814.
11.
Leff, A.A., Lester, W.T., Addinglow, W.W.Tuberculosis, a chemotherapeutic triumph but a persistent socio-economic problem . Arch Intern Med1979; 139: 1375-1377.
12.
Lundgren, R. , Norrman, E., Asberg, I.Tuberculosis infection transmitted at autopsy . Tubercle1987; 68: 147-150.
13.
Monie, R.D.H. , Hunter, A.M.Rocchiccioli, K., White, J., Campbell, I.A., Kilpatrick, G.S.Survey of pulmonary tuberculosis in South and West Wales (1976-78). Br Med J (Clin Res)1982; 284: 571-573.
14.
Rosenthal T. , Pitlik, S., Michaeli, D.Fatal undiagnosed tuberculosis in hospitalised patient. J Infect Dis1975; 131 (Suppl): 51-56.
15.
Teppo, L., Ojajarvi, J., Brander, E.Tuberculosis morbidity among pathologists in Finland. Scand J Resp Dis1974; 55: 257-260.
16.
Treip, C., Meyers, D.Fatal tuberculosis in a general hospital — a diagnostic problem. Lancet1959; 1: 164-167.