Source: Annual Congress 2006 - Clinical aspects of tuberculosis
Disease area: Respiratory infections

Abstract

This paper reviews the referral diagnostic of hospitalized patients between January 2001 and December 2003 and presents the problems in the tuberculosis ambulatory diagnostic process. The patients were divided in two groups: a) group 1 – 147 under-diagnosed tuberculosis patients (87 men, 60 women, mean age 44.2 years); b) group 2 – 184 over-diagnosed tuberculosis patients (126 men, 58 women, mean age 50 years). There were 4 hospital admission proceedings: sent by ambulatory pneumology specialist – 32.6% cases in the first group and 66.3% in the second group, sent by family doctor – 27.2% respectively 23.4%, emergency – 33.3% respectively 7.6%, sent by other specialists – 6.9% respectively 2.7% cases. Only chest radiology was used to examine the patients in ambulatory, and the most atypical X-rays findings were: pneumonia – 41.5% cases in the first group and 51.6% in the second group, lung cancer – 6.1% respectively 9.2%, abscess – 8.8% respectively 2.2% cases. In the first group 65.3% patients were smear-positive and 13% culture-positive, and in the second group all patients were smear and culture-negative. In conclusion, in Romania, a lot of patients are still detected with significant symptoms (haemoptysis, respiratory failure, fever). Delays in the diagnostic can be attributed to less expertise among family doctor and the increasing numbers of suspects presented with only clinical suspicion or atypical X-rays, without sputum smear microscopy and culture. The pneumology specialist have the highest index of suspicion.

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Citations should be made in the following way:
O. I. Nicolaescu (Bucharest, Romania). Between the supravaluation and undervaluation tuberculosis diagnostic in ambulatory service in Bucharest. Eur Respir J 2006; 28: Suppl. 50, 826

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