Errors in Diagnosing Infectious Diseases: A Physician Survey

Abstract

Background: Infectious diseases are commonly missed or misdiagnosed. Errors in diagnosing infectious diseases not only affect the patient but also the community health.Objectives: To describe our investigation on the most common errors in diagnosing infectious diseases and their causes according to the physicians' reports.Methods: Between August 2018 and February 2019, specialist physicians and residents across Mashhad, Iran were invited to participate in a survey to report errors they had made or witnessed regarding the diagnosis of infectious diseases.Results: Overall, 465 cases were reported by 315 participants. The most common infectious diseases affected by diagnostic errors were upper respiratory tract infections (URTIs) (n = 69, 14.8%), tuberculosis (TB) (n = 66, 14.1%), pleuro-pulmonary infections (n = 54, 11.6%), central nervous system (CNS) infections (n = 51, 10.9%), and urinary tract infections (n = 45, 9.6%). Errors occurred most frequently in generating a diagnostic hypothesis (n = 259, 55/7%), followed by history taking (n = 200, 43%), and physical examination (n = 191, 41/1%). Errors related to the diagnosis of TB (odds ratio [OR]: 2.4, 95% confidence interval [CI]:0.9–5.7; P value: 0.047) and intra-abdominal infections (OR: 7.2, 95% CI: 0.9–53.8; P value: 0.02) were associated with more-serious outcomes.Conclusion: A substantial proportion of errors in diagnosing infectious diseases moderately or seriously affect patients' outcomes. URTIs, TB, and pleuropulmonary infections were the most frequently reported infectious diseases involved in diagnostic error while errors related to the diagnosis of TB and intraabdominal infections were more frequently associated with poor outcomes. Therefore, contagious and potentially life-threatening infectious diseases should always be considered in the differential diagnosis of patients who present with compatible clinical syndromes.

Development of a loop-mediated isothermal amplification (LAMP)-based electrochemical test for rapid detection of SARS-CoV-2

“…The average current was ∼30 μA for a positive LAMP reaction where the isothermal amplification was conducted either in a Genie II instrument or on a heat block ( Figure S2 ). We calculated the LOD for the electrochemical LAMP by diluting synthetic RNA from 10 −0 to 10- 10 (0.1attograms) in nuclease free water. The LOD of electrochemical-RDT was recorded to be 10 − to8 -fold dilution of 1ng (10attograms) which accounts for 5.29 copies of ssRNA per reaction or 5.29 × 10 3 copies/mL ( Figures 2 C and 2D).…”

“…Misdiagnosis or inaccuracies in diagnosis leads to adverse clinical outcomes and even mortality, such as reported in cases of COVID-19, tuberculosis, respiratory tract infections, and sepsis diagnosis. 8 , 9 , 10 Sensitive and specific diagnostic tests are therefore crucial to provide accurate identification of the cause of the disease, and appropriate timely treatment and control measures. 11 Advances in molecular techniques have revolutionized diagnostics in development of fast, reliable, efficient, and cost-effective techniques.…”

Investigating Causes of Medical Errors in Intensive Care Units in Iran: A Cross-sectional Study

“…Patient safety is one of the principal features of the quality of health care systems, attempting to assure that a medical treatment plan will proceed properly and provide the optimum quality of care to achieve the best outcome ( 1 ). Intensive care units (ICUs) have emerged to bring together well-trained medical teams to provide care for patients with life-threatening diseases ( 2 ).…”

Editorial: Photonics-based diagnosis and treatment of infectious and inflammatory diseases

“…This has occurred, in part, because of the precautionary administration of antibiotics, prior to a definitive diagnosis (Antoñanzas et al, 2022). Because numerous infection syndromes can look similar (Haddad et al, 2021), without a proper diagnosis, appropriate treatment is often delayed. Adding insult to injury, the propensity for resistance development is further perpetuated via this application of unnecessary antibiotics that induce selective pressure on commensal organisms, which can eventually transfer resistance to pathogenic strains (Crits-Christoph et al, 2022).…”