جستجوی مقالات مرتبط با کلیدواژه "Misdiagnosis" در نشریات گروه "پزشکی"
-
The patients with unusual symptoms present a diagnostic challenge for clinicians and may lead to misdiagnoses and inappropriate or unnecessary treatments. Endodontic diseases can present with a variety of symptoms, and it is possible for odontogenic pain to resemble non-odontogenic pain, which can complicate treatment due to the distinct management plans of the two conditions. This report details the successful management of vague pain, and popping sensations in the left maxilla triggered by cold exposure. Previous clinicians were unable to identify the pain's origin, leading to unnecessary treatments. A clinical examination, and cone-bea m computed tomography evaluation revealed the presence of a missed second mesiobuccal root canal. The canal was located using an operating microscope and ultrasonics. Non-surgical endodontic retreatment was completed in two visits, successfully. This report highlights the critical importance of identifying the diverse symptoms that may arise from endodontic origin, as these can complicate clinical diagnosis.
Keywords: Diagnostic Error, Misdiagnosis, Endodontic Inflammation, Endodontically Treated Tooth, Pain Management, Root Canal Therapy -
زمینه و هدف
به تازگی انجمن سلیاک کشور پروتکلی برای ثبت بیماران تهیه کرده که برگرفته از به روزترین مقالات در زمینه سلیاک بوده و از تشخیص بیش از حد یا کمتر از واقع سلیاک جلوگیری می کند و از تمامی استانها خواسته شده که بیمارانی که در این پروتکل جای نمی گیرند از این سیستم خارج نمایند. در این میان مواردی از عدم تطابق بیماران ما با پروتکل کشوری به وجود آمده که در این مقاله برآن شدیم تا به بررسی میزان تطابق پروتکل کشوری بیماری سلیاک با سیستم ثبت استان و علل آن بپردازیم.
روش بررسیدر طی این مطالعه که یک مطالعه ی توصیفی-تحلیلی می باشد پرونده تمامی بیماران مبتلا به سلیاک که بر اساس نظر علمی فوق تخصص گوارش و با نامه ی معرفی، در سیستم ثبت سلیاک وارد شده اند (حدود 250نفر) مورد بررسی (از نظر انطباق با پروتکل کشوری) قرار گرفتند. موارد عدم تطابق استخراج شده و علت این تفاوت نیز ذکر شد.
یافته هااز بین 250نفر بیماران مبتلا به سلیاک 88نفر (35.2درصد) که کرایتریای عملی متخصصین استان با پروتکل کشوری مطابقت نداشت انتخاب شدند. میانگین سنی شرکت کنندگان 37.19±19.31سال بود که کم ترین سن 3سال و بیشترین سن 86سال داشت. 28نفر(31.8درصد) شرکت کنندگان مرد و 60نفر(68.2درصد) شرکت کنندگان زن بودند. در 36فرد (40.9درصد) فقط تست پاتولوژی، در 46فرد(52.3درصد) فقط سرولوژی و در 6فرد (6.8درصد) نیز هر دو تست (پاتولوژی + سرولوژی) انجام شده ولی پزشک به تشخیص نرسیده است. نتیجه تست براساس طبقه بندی مارش Iدر 1فرد(0.5درصد افراد،) مارش IIدر 8فرد(19درصد،) مارش III aدر 15فرد(35.7درصد،) مارش III bدر 10فرد (23.8درصد) و مارش III cدر 8فرد(19درصد) بود.
نتیجه گیریبه طور کلی نتایج حاصل از مطالعه ما نشان داد که پروتکل کشوری تشخیص سلیاک با موارد ثبت شده در تمامی موارد تطابق ندارد که با بررسی های انجام شده در منابع معتبر علمی به نظر میرسد پروتکل کشوری از منطق علمی موثقی بر خوردار است.
کلید واژگان: بیماری سلیاک, تشخیص اشتباه, ایرانGovaresh, Volume:28 Issue: 4, Winter 2024, PP 217 -223BackgroundThe Celiac National Institute has recently devised a diagnostic algorithm for celiac, which has been adopted from the most recent guidelines and articles worldwide. All Iranian provinces are requested to set all diagnoses based on the newest national protocol devised by the National Institute of Celiac Disease; however, some incompatibilities are observed. Therefore, this study was conducted to demonstrate these incompatibilities.
Materials and MethodsIn this descriptive-analytical study, we enrolled 250 cases of celiac disease referred to the province registry system and revised the diagnosis based on the national protocol for celiac disease diagnosis. All data were analyzed using SPSS software version 26.
ResultsAmong the 250 patients diagnosed with celiac disease, 88 (35.2%) had incompatibility. The mean age of the patients was 37.19 years. 28 people (31.8 %) were men. Results indicated that in 40.9% of incompatibility cases, only pathology tests were performed, and in 52.3% of incompatibility cases, only serological tests were performed. In 6.8% of cases, both tests were performed, but the diagnosis was indefinite. Pathological results indicated that 0.5% of patients were in Marsh 1, 19% in Marsh 2, 35.7% in 3a, 23.8% in 3b, and 19% in Marsh 3c phases.
ConclusionThere are cases of diagnostic incompatibilities between the most recent national protocol for celiac disease and physicians’ practice. Therefore, it is vital that practitioners are trained with the national protocol for celiac disease diagnosis..
Keywords: Celiac disease, Misdiagnosis, Iran -
زمینه و هدف
گیرنده PD-1 یا مرگ برنامه ریزی شده سلولی-1، یکی از گیرنده های مهم مهارکننده در حفظ تحمل یا تولرانس و مهار تکثیر و فعالیت سلول های ایمنی فعال است. PD-1 تکثیر سلول های T تنظیمی و مهار سلول های T خود واکنشگر را افزایش می دهد و تحمل مرکزی و محیطی را تنظیم می کند. مولتیپل اسکلروزیس (MS) و نورومیلیت اپتیکا (NMO) اختلالات عصبی هستند که با التهاب، دمیلینه شدن توسط سیستم ایمنی و آسیب آکسونی و عصبی در سیستم عصبی مرکزی مشخص می شوند. تظاهرات بالینی NMO بسیار شبیه به MS است و منجر به تشخیص اشتباه می شود. بنابراین وجود بیومارکرها یا نشانگرهای تشخیصی خاص برای تشخیص صحیح بیماری های مدنظر، از اهمیت ویژه ای برخوردار است.
مواد و روش هادر اینجا، بیان ژن PD-1 را در 40 بیمار MS، 20 بیمار NMO و 15 فرد سالم بررسی کردیم. بدین منظور، پس از استخراج RNA از خون افراد مورد مطالعه و سنتز cDNA، بیان ژن PD-1 با استفاده از روش کمی PCR مورد بررسی قرار گرفت.
یافته هانتایج نشان می دهد که بیان mRNA ژن PD-1در خون محیطی گروه بیماران MS در مقایسه با گروه بیماران NMO و گروه افراد سالم به طور قابل توجهی افزایش یافته است (به ترتیب با احتمال معنا داری 0/0008=p و 0/0024=p) با این حال، از نظر آماری تفاوت معنی داری در بیان mRNA ژن PD-1 بین گروه NMO و گروه سالم وجود نداشت.
بحث و نتیجه گیرینتایج مطالعه ما نشان می دهد که سطح بیان mRNA PD-1 در بین بیماران این دو گروه تفاوت معنی داری دارد و پس از انجام مطالعات بیشتر در این زمینه، می توان از این ژن به عنوان بیومارکر تشخیصی برای افتراق این دو بیماری استفاده کرد.
کلید واژگان: مولتیپل اسکلروزیس, نورومیلیت اپتیکا, تشخیص اشتباه, PD-1, PD-L, سلول T, بیان ژنProgrammed cell death-1 (PD-1) is one of the important co-inhibitory receptors in maintaining tolerance and inhibiting the proliferation and activity of activated immune cells. PD-1: PD-L pathway enhances regulatory T cells proliferation and inhibition of autoreactive T cells and regulates central and peripheral tolerance. This pathway has affected various aspects of the immune system and is of particular importance in a variety of diseases, such as autoimmune diseases. Multiple sclerosis (MS) and Neuromyelitis Optica (NMO) are neurological disorders characterized by inflammation, demyelination by the immune system, and axonal and neuronal damage in the CNS. The clinical manifestations of NMO are very similar to MS and lead to a misdiagnosis. Therefore, the existence of specific diagnostic markers is of particular importance for correct diagnosis. Here, we examined the expression of the PD-1 gene in 40 MS patients, 20 NMO patients, and 15 healthy individuals. Thus, after RNA extraction from human blood and cDNA synthesis, gene expression of PD-1 was investigated using quantitative real-time PCR technique. The results show that the PD-1 mRNA expression in the peripheral blood of the MS group was significantly increased in comparison to that of the NMO group and healthy group (p= 0.0008, p= 0.0024, respectively). However, there was no significant difference in PD-1 mRNA expression between the NMO group and the healthy group.
Keywords: Multiple Sclerosis, Neuromyelitis Optica, Misdiagnosis, PD-1, PD-L, T Cell, Gene Expression -
Alveolar echinococcosis (AE) is an important zoonotic tropical disease in China that affects people living in western endemic areas. The disease is prone to occur in the liver with a characteristic similar to slow-growing malignant tumors. We report a 31-year-old male patient with serious complication after hepatorrhaphy, who had presented with clinical manifestations of hepatapostema with infection. Ultrasound (US) and computer tomography (CT) are two important medical imaging modalities to diagnose hepatic AE. Based on the medical history, clinical findings, laboratorial and imaging results, the patient was misdiagnosed with hepatapostema. A series of subsequent treatments were ineffective. Finally, partial hepatectomy was performed, and postoperative pathological results confirmed hepatic AE. The patient has now recovered.
Keywords: Alveolar echinococcosis, Misdiagnosis, Ultrasound, Case report -
Introduction
Crimean Congo hemorrhagic fever (CCHF) is a tick-borne, zoonotic disease distributed globally. As the clinical features of CCHF and COVID-19 are similar, getting an early and reliable diagnosis may be difficult.
Case PresentationWe report the first misdiagnosed case of CCHF in the setting of a COVID-19 pandemic from Ravansar County of Kermanshah province in Iran. Our patient was initially misdiagnosed with COVID-19, got hospitalized, but later tested positive for CCHF. However, the delay in diagnosis caused her death.
ConclusionsCrimean Congo hemorrhagic fever should be considered among people in endemic areas who show COVID-19 symptoms for urgent medical attention.
Keywords: CCHF, COVID-19, Iran, Symptoms, Misdiagnosis -
Introduction
Although indigenous malaria cases have dramatically declined over the past decades, the COVID pandemic has continued to affect the programs designed to combat malaria, particularly in those countries where hydroxychloroquine and chloroquine have been used as medications for treating COVID. Two immigrants entered Iran illegally from neighboring countries (i.e., Afghanistan and Pakistan). This study mainly aimed to assess the effects of coronavirus disease (COVID-19) on these cases from all aspects (i.e., case-finding, diagnosis, and treatment).
Case PresentationBoth cases presented withcommonsymptoms such as fever and shaking chills. In addition, they had no sign of COVID-19, and their oxygen level and CT images were normal in some cases, but they were mistakenly treated as COVID-19 patients long after the onset of malaria symptoms. One of the suspected coronavirus cases was given chloroquine on a voluntary basis for one day, which may have been responsible for the possible relapse in vivax or resistance of plasmodium vivax to chloroquine and the recurrence of parasitemia in falciparum.
ConclusionsThe active case detection of malaria was affected by the COVID-19 pandemic. Case finding was dramatically decreased with the onset of coronavirus, thereby causing a spurt in malaria incidence. Moreover, the malaria treatment strategywasnegatively affected by the misdiagnosis of COVID-19.
Keywords: Imported Malaria, COVID-19, Chloroquine, Case-Finding, Misdiagnosis -
Introduction
During the coronavirus disease 2019 (COVID-19) pandemic, physicians delivered a leading part and carried a high work volume, leading to burnout, which subsequently compromised patient safety, decreased the quality of care, and increased misdiagnosis. In the course of the COVID-19 pandemic, physicians should have been vigilant and informed about the potential conditions resulting in medical errors. Particularly, epidemics of infectious illnesses can cause serious challenges in lymphoma diagnosis.
Case PresentationThis case report presents a patient with lymphoma presenting with cough, fever, shortness of breath, and a history of contact with her familymemberswhotested positive for COVID-19, whichcaused delayed diagnosisandtreatment, disease progression, and finally, the death of the patient. In the course of the COVID-19 pandemic, the center of attention was detracted from other possible diagnoses, thereby missing lymphoma as a potentially treatable disease.
ConclusionsAlthough physicians are required to be watchful for COVID-19 amid the pandemic, it is also necessary not to neglect other diseases. A delay in the initiation of cancer therapy, even for one month, has been reported to increase the risk of mortality by approximately 10%.
Keywords: Misdiagnosis, COVID-19, Lymphoma, Coronavirus -
COVID-19 has recently become a pandemic. Early diagnosis and the transmission chain cutting off are critical keys to controlling this disease and stopping its spread. In this case report, the significance of proper and on-time diagnosis is discussed. Misdiagnosis of COVID-19 may lead to delay in early diagnosis of the disease. A 78-year-old man with the chief complaint of dark stool and constipation was admitted. Based on the preliminary complaints of the patient, the emergency medical specialist transferred him to the internal caregiving service, but according to radiological findings and his positive Real-time PCR test, COVID-19 was the final diagnosis. Healthcare planners and policymakers should prepare precise clinical guidelines that are compatible with domestic conditions of the country to improve the ability of healthcare providers to diagnose patients with COVID-19 to promote controlling this condition.
Keywords: Coronavirus disease 2019 (COVID-19), Misdiagnosis, Gastroenteritis -
سابقه و هدف
سالنامه آماری پزشکی قانونی نشان دهنده افزایش سالانه تعداد پرونده های ارجاعی به کمیسیون های پزشکی به دلیل شکایت از «خطای تشخیصی در موارد سقط درمانی» است. اگرچه شاید یکی از دلایل افزایش تعداد شکایات، افزایش تعداد مراجعان باشد، اما با توجه به به روز شدن اندیکاسیون های مادری و جنینی سقط جنین درمانی و تدوین دستورالعمل های جدید، ارزیابی عملکرد متخصصان پزشکی قانونی در رابطه با میزان رعایت آخرین قوانین مصوب در راستای یافتن علل روند صعودی شکایات ضروری به نظر می رسد.
روش کاردر این مطالعه به صورت پرونده خوانی با روش داده های موجود، تمامی نظریات صادره در پرونده های ارجاعی به اداره کمیسیون های پزشکی استان تهران به دلیل شکایت از «خطای تشخیصی در موارد سقط درمانی» از آغاز سال 1395 تا پایان سال 1398 بررسی شد. خطای تشخیصی در پرونده های شکایت با موضوع سقط جنین درمانی در خصوص اندیکاسیون های جنینی به معنای عدم درخواست به موقع آزمایشات و یا سونوگرافی های مرتبط با شکایت مانند اکوکاردیوگرافی قلب جنین - آزمایش بررسی ژن - آزمایشات ژنتیک (کاریوتیپ - سیتوژنتیک - تست سریعRapid Test) - درخواست مشاوره با پریناتولوژیست - درخواست های مشاوره با درخواست مشاوره های پزشکی تخصصی بر اساس بیماری مادر یا آنومالی جنین و...) توسط متخصص زنان و زایمان؛ عدم تشخیص ناهنجاری جنین توسط رادیولوژیست یا پریناتولوژیست، عدم تشخیص و گزارش نادرست در موارد انجام آزمایش بررسی ژن و یا آزمایشات ژنتیک (کاریوتیپ - سیتوژنتیک - تست سریع Rapid Test توسط متخصص ژنتیک و آزمایشگاه و در خصوص اندیکاسیون های مادری سقط درمانی، عدم تشخیص به موقع بیماری زمینه ای مادر توسط پزشکان متخصص و فوق تخصص رشته های پزشکی بسته به نوع بیماری مادر بررسی شد.
یافته هااز مجموع 22 پرونده موجود، نظریات صادره درتمامی موارد مطابق با آخرین قوانین مصوب در ایران بود. بیشترین میزان شکایات (40/9درصد) از متخصصان زنان و زایمان بود. بررسی نظریات صادره، نشان دهنده شش مورد (27/3درصد) خطای انتظامی، 15 مورد (68/2درصد) برایت و یک مورد (4/5درصد) عدم امکان صدور نظریه بدلیل نقص مدارک و مستندات موجود در پرونده بود.
نتیجه گیریبه نظر می رسد که نظریات صادره در کمیسیون پزشکی تهران مغایرتی با قوانین سقط جنین درمانی ندارد. انجام مطالعات بیشتر در سایر کمیسیون های پزشکی را توصیه می گردد.
کلید واژگان: سقط جنین پزشکی, خطای تشخیصی, خطای پزشکیBackground and AimThe statistical yearbook of forensic medicine shows an annual increase in the number of cases referred to medical commissions due to complaints of "misdiagnosis in abortion cases. Although perhaps one of the reasons for the increase in the number of complaints is the increase in the number of clients, considering the updating of maternal and fetal indications for therapeutic abortion and the development of new guidelines, the performance evaluation of forensic experts in relation to the extent of compliance with the latest approved laws in order to find the causes of the trend The rise of complaints seems necessary.
MethodsIn this Existing data study, all the opinions issued in the cases referred to the medical commissions department of Tehran province due to the complaint of "diagnostic error in abortion cases" from March 2016 to March 2020 were reviewed. Diagnostic error in complaint files regarding abortion treatment regarding fetal indications means not requesting timely tests or sonograms related to the complaint, such as echocardiography of the fetal heart - gene screening test - genetic tests (karyotype - cytogenetic - rapid test) Consultation request with a perinatologist - consultation requests with the relevant specialist depending on the type of maternal disease or fetal anomaly, etc.) by the obstetrician and gynecologist; failure to diagnose fetal abnormalities by radiologists or Perinatologists; Non - diagnosis and incorrect reporting in the cases of gene testing - genetic tests (karyotype - cytogenetic - rapid test by genetics specialist and laboratory and regarding maternal indications for abortion therapy, failure to timely diagnose the mother's underlying disease by specialist and subspecialist doctors in the field Medical treatment depends on the type of mother's illness.
ResultsOut of a total of 22 existing cases, the opinions issued in all cases were in accordance with the latest laws approved in Iran. The highest number of complaints (40.9%) was from gynecologists and obstetricians. Review of issued ideas indicated 6 cases (27.3%) of disciplinary error, 15 cases (68.2%) of acquittal, and 1 case (4.5%) of the impossibility of issuing a theory due to the lack of evidence and documentation in the file.
ConclusionIt seems that the views issued by the Tehran Medical Commission do not conflict with the laws of medical abortion. It recommends conducting more studies in other medical commissions.
Keywords: medical abortion, misdiagnosis, medical malpractice -
Purpose
To study the clinical presentation and highlight the “diagnostic clinical features” in patients having lacrimal canaliculitis (LC).
MethodsA retrospective analysis of all patients diagnosed with primary and secondary LC was performed. A detailed slit‑lamp examination of the conjunctiva, lacrimal punctum, canalicular region, and lacrimal sac was performed. Common and coexisting clinical features were highlighted. The posttreatment sequence of resolution of clinical features was also noted.
ResultsForty eyes of 36 patients (28 females, 77.78%) with a mean age of 59.5 years were included in the study. Thirty eyes (75%) had primary LC, whereas 10 had a secondary type. Previous misdiagnoses were noted in 34 (85%) eyes. The highlighting clinical features were medial eyelid edema (n = 40, 100%), pouting and hyperemia of lacrimal punctum (n = 36, 90%), yellowish canalicular hue (n = 35, 87.5%), and canalicular distention and expressible discharge (n = 32, 80%). None had features suggestive of nasolacrimal duct obstruction. Thirty‑two eyes (80%) showed all four clinical features of LC, a tetrad. At a mean follow‑up of 14.5 months, the complete resolution was noted in 36 (90%) eyes.
ConclusionsWe propose a “clinical tetrad” of 1. medial eyelid edema, 2. pouting and hyperemia of lacrimal punctum, 3. yellowish canalicular hue and, 4. canalicular distention, and expressible discharge, for the easier clinical diagnosis of LC. The authors believe that using this clinical tetrad may be helpful for the diagnosis of LC.
Keywords: Canaliculitis, Lacrimal canaliculitis, Lacrimal tetrad, Misdiagnosis, Tetrad -
Malignant skin ulcerations may mimic diabetic foot ulcers leading to misdiagnosis. In this case report, we discuss an uncommon but severe problem of malignant tumors initially misdiagnosed as diabetic foot ulcers, underlying the need to improve medical awareness, diagnostics, and approaches for therapy once the correct diagnosis is made. We describe the case of an 82-year-old male with diabetes mellitus and melanoma metastases initially misdiagnosed as diabetic foot ulcers. In diabetic patients, several skin disorders may coexist on the same foot, including actual diabetic foot ulcers and skin cancers. Among multiple skin disorders that coexist on the foot of a diabetic patient, the skin metastases may be misdiagnosed as diabetic foot ulcers. Significant efforts should be made to create new non-invasive, rapid diagnostic techniques to eliminate misdiagnoses of skin disorders in diabetic patients.
Keywords: Diabetic foot ulcer, Melanoma, Misdiagnosis, Skin cancer, Case report -
Composite hemangioendothelioma (CHE) is a rare and little-known condition with combined benign, intermediate, and malignant features. In the current study, we describe the case of a young female with the presentations of CHE, representing the second known case in Iran. Also, we have comprehensively reviewed previous case reports of CHE. A 30-year-old female was referred with a reddish hemorrhagic painless mass in the small right finger that appeared within a few days following trauma. The mass was primarily excised but recurred within three weeks; therefore, she underwent thorough clinical, laboratory, and imaging studies. Finally, the lesions were biopsied and diagnosed as CHE. Accordingly, the involved finger was amputated, and the patient underwent chemoradiotherapy. Although CHE is a rare malignant condition worldwide, attention to the clinical presentations of this malignancy can help scientists make better therapeutic approaches leading to the best outcomes.
Keywords: Hemangioendothelioma, Malignancy, misdiagnosis -
Medical problems are common in psychiatric patients, especially in patients with schizophrenia, so more attention should be considered. Benign tumors such as Vestibular Schwannoma (VS) are also a rare condition that may occur in psychiatric patients. This study presented a 36-years-old married woman known case of schizophrenia and with cerebellopontine angle (CPA) following atypical facial pain. This study aims to draw the attention of physicians, psychiatrists, mental health personnel, and internal care to the physical and medical issues of chronic psychiatric patients. In addition, misdiagnosis in these patients can cause more problems, and drug-drug interactions can be important.
Keywords: Vestibular Schwannoma, Schizophrenia, Pain, Misdiagnosis -
Tooth impaction is defined as a partial or complete eruption of a tooth regarding the eruption time. Hereby, we present an infectious canine in a 38-year-old man that primarily presented with chest pain and dyspnea. After two days, he demonstrated a painful swelling and erythema of the face, severe perspiration, nasal congestion, and pleural effusion. The patient was diagnosed with acute bronchitis, mucormycosis, and nasal septum abscess, leading to unnecessary antibiotic therapy and lack of treatment response. After oral and maxillofacial surgery consultation, cone-beam computed tomography (CBCT) revealed an impacted and infectious canine that was surgically extracted. Due to lack of desired response to treatment, he underwent CBCT after oral and maxillofacial surgery consultation. An impacted and infectious canine was detected, which was surgically extracted. Three days later, his symptoms significantly improved, and he was discharged with a stable general condition
Keywords: Infectious Impacted Canine, Misdiagnosis, Mismanagement -
مقدمه
تینه آکاپیتیس (Tinea capitis) شایع ترین عفونت در سر است و یک درماتوفیتوز غیرمعمول در بزرگسالان است. ظاهر بالینی آن بسته به ارگانیسم ایجادکننده، نوع حمله به مو و میزان پاسخ التهابی میزبان بسیار متغیر است. از ویژگی های رایج آن، ریزش موی تکه ای با درجات مختلف پوسته ریزی و اریتم است. با این حال، اگر علایم بالینی خفیف باشد، تشخیص می تواند چالش برانگیز باشد.
گزارش موردما در این مطالعه یک مورد تینه آکاپیتیس را در یک خانم 60 ساله گزارش می کنیم که در ابتدا علایم بالینی او اندک بود و با توجه به پاسخ بیوپسی و حضور فیبروز، لیکن پلانوپیلاریس تشخیص داده شد و درمان مربوط با آن یعنی متوتروکسات و سیکلوسپورین را دریافت کرد اما پس از 4 ماه، عدم پاسخ به درمان و تشدید علایم مشاهده شد. با معاینه و نمونه ی بیوپسی مجدد و علایم بالینی تشدیدیافته، تینه آکاپیتیس تشخیص داده شد و درمان مربوطه به بیمار داده شد.
نتیجه گیریتینه آکاپیتیس می تواند بعضی از ویژگی های بالینی لیکن پلانوپیلاریس را نشان دهد و با درمان نادرست با داروهای کورتیکواستروییدها گسترش یابد.
کلید واژگان: تینه آ کاپیتیس, لیکن پلانوپیلاریس, تشخیص اشتباهIntroductionTinea capitis is the most common skin infection on the scalp and an uncommon dermatophytosis in adults. Its clinical appearance varies greatly depending on the causative organism, the type of hair involvement and the extent of the patient inflammatory response. Its common features are fragmented hair loss with varying degrees of scaling and erythema. However, if the clinical symptoms are mild, the diagnosis can be challenging.
Case reportWe report a case of tinea capitis in a 60-year-old woman who initially had few clinical symptoms and according to the biopsy result and the presence of fibrosis, lichenpilanopilaris (LPP) were diagnosed and she received related treatment with methotrexate and cyclosporine, but after 4 months, no response to treatment and exacerbation of symptoms were observed. Tinea capitis was diagnosed and the patient was given appropriate treatment.
ConclusionTinea capitis can imitate clinical features of lichenplanopilaris and mistreatment with corticosteroids can lead to extension of the disease.
Keywords: tinea capitis, lichenpilanopilaris, misdiagnosis -
Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.
Keywords: Endodontics, Misdiagnosis, Infection, Odontogenic Cysts -
Background
The accurate diagnosis of etiologic agents of diseases, including Plasmodium species, is a major challenge to effective control programs in sub-Saharan Africa. Malaria misdiagnosis hinders prompt treatment of infected patients, which increases malaria morbidities and mortalities.
ObjectivesA study to evaluate the prevalence and misdiagnosis of Plasmodium species using microscopy and polymerase chain reaction (PCR) technique in two tertiary care hospitals in Rivers State was conducted.
MethodsA cross-sectional randomized study involving 2,000 participants (age and sex were noted) was conducted from January 2016 to December 2017, and only patients arriving in the Outpatient Clinic of the selected tertiary care hospitals were recruited for this study. Intravenous blood samples (5 mL) were collected from all study participants and analyzed for the presence of Plasmodium species using Giemsa-microscopy and Real-time PCR technique. All data generated were analyzed using analysis of variance (ANOVA) and Chi-square test. A P < 0.05 was considered statistically significant.
ResultsThe only species of Plasmodium observed in this study was Plasmodium falciparum (P. falciparum), and the overall prevalence in the study was 37.65% and 34.0% for microscopy and PCR, respectively (P > 0.05). Microscopy had a 3.5% variation and misdiagnosis of 5.5% compared with PCR. P. falciparum misdiagnosis according to age was 6.6%, 4.8%, 3.2%, 7.3% and 6.7% for age groups 0-10, 11-20, 21-30, 31- 40, and > 40, respectively while males and females had P. falciparum misdiagnosis of 6.9% and 4.5%, respectively (P > 0.05). Microscopy had sensitivity, specificity, and diagnostic accuracy of 95.8%, 94.3%, and 94.9%, respectively.
ConclusionsMicroscopy remains the gold standard for Plasmodium species diagnosis, and suspected malaria cases should be confirmed with an efficient laboratory diagnosis before treatment to prevent misdiagnosis or antimalarial drug resistance.
Keywords: Prevalence, PCR, microscopy, Misdiagnosis, Plasmodium -
Introduction
Cervicogenic headache is known to be the most controversial type of headache, because its diagnosis is difficult and usually associated with errors. The signs and symptoms of this headache confuse therapists and cause misdiagnosis; definitive diagnostic criteria and physical tests should be used to accurately diagnose cervicogenic headaches. The current study investigated patients suffering from headaches, then reassessed them using a new diagnosis protocol, and finally provided them with physiotherapy using clinical reasoning strategies.
Materials and MethodsIn this study, three patients who had suffered headaches and tolerated inappropriate treatment due to misdiagnosis were evaluated using diagnostic criteria and physical examination based on the International Headache Society (IHS) criteria. Cervicogenic headache was diagnosed, and accordingly, physiotherapy with a multi-modal intervention approach based on clinical reasoning was administered. The outcome of treatment was assessed using the headache index questionnaire.
ConclusionSubjects who had suffered, on average, 15 years of chronic, medicine resistance headaches were evaluated. Cervicogenic headache was diagnosed in each of them and physiotherapy was begun. An average improvement rate of 74% was achieved based on the headache index formula. It can be concluded that the use of physical tests in addition to diagnostic criteria will decrease the rate of misdiagnosed cervicogenic headache, and physiotherapy can be the appropriate treatment.
Keywords: Cervicogenic headache, Physiotherapy, Misdiagnosis, Multimodal interventions -
Background
Ancylostomiasis is a prevalent and global parasitic disease, including China. A systematic review is significant to understand the epidemiological features of hookworm and provide guidance for prevention and treatment.
MethodsWe systematically searched academic databases and assessed 944 papers published from1955-2015 to establish the comprehensive analysis of prevalence of hookworm disease in China. We searched Chinese databases, including CNKI, Wanfang and VIP, for literature with the subject word "Ancylostomiasis and hookworm". The data were analyzed with SPSS 19.0 software using Spearman correlation analysis. Results were statistically significant for a P-value of <0.01.
ResultsThe search yielded 532,151 cases from epidemiological investigation and 7294 cases based on hospital diagnosis. Hookworm infection was highest (15.83%) in Fujian province, with high rates also found in East China, Southwest China, Central China and Southern China and lower rates in Northwest China, North China and Northeast China. In terms of occupation, farmers had the highest proportion of infections (72.54%). There was no correlation between epidemiological investigations and hospital-diagnosed cases. However, there was significant positive correlation between hospital-diagnosed cases and misdiagnosed cases. The proportion of hospital-misdiagnosed cases was 32.80%.
ConclusionAncylostomiasis is a serious public health problem that negatively influences health and hinders socioeconomic development. Positive measures are required by both health services and individuals to prevent and control hookworm disease.
Keywords: Hookworm, Epidemiological features, Hospital cases, Misdiagnosis -
BackgroundAppendicitis is the inflammation of the appendix. In spite of advances in the diagnosis and management of acute appendicitis, its morbidity is still significant. Despite widespread use of ultrasonography, computed tomography (CT) scan, and laparoscopy to diagnose appendicitis, the rate of misdiagnosis is not diminished accordingly.MethodsThe current study aimed at determining the prevalence of primary misdiagnosis in pediatric patients presenting with appendicitis to Aliasghar Hospital, a tertiary referral center in Tehran, Iran from 2005 to 2015.ResultsIn the present study, the misdiagnosis rate of acute appendicitis was 7.4% in 10 years. Most causes of misdiagnosis were mesenteric adenitis, urinary tract infection, and gastroenteritis. Despite the availability of various diagnostic methods, the majority of patients with initial misdiagnosis were finally subjected to laparotomy for acute appendicitis. Ultrasound examination was useful in only 23% of the cases. Location of appendicitis in patients with initial misdiagnosis was retrocec in nine patients (53%), retroileum in five patients (29%), and pelvis in three patients (18%).ConclusionsCloser attention to signs and symptoms of acute appendicitis and higher clinical suspicion could reduce the rate of misdiagnosis and therefore minimize complications.Keywords: cute Appendicitis, Diagnosis, Complications, Misdiagnosis
- نتایج بر اساس تاریخ انتشار مرتب شدهاند.
- کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شدهاست. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
- در صورتی که میخواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.