The undoing of a diagnosis: the effect of a misdiagnosis of a disease

Article Abstract:

Undoing a misdiagnosis of chronic disease in a child may be difficult, take time, and require good communication skills by medical staff. Eighteen pediatric patients with a diagnosis of cystic fibrosis were found on subsequent testing not to have the disease. Three to 12 years had elapsed since the original diagnosis, and none had experienced symptoms of disease-related illness. All children were being treated for their presumed disease. When informed of the misdiagnosis, all parents expressed disbelief and suspicion. They requested repeated tests and were reluctant to discontinue therapy. Most parents experienced an extended period of anger at the doctor communicating news of the misdiagnosis, the doctor who made the diagnosis, or both. Parents took as long as three years to believe the child was healthy. Even then, minor illness could raise acute anxiety. Diagnosis had been made on scanty grounds, pointing out the need for extreme care in diagnosing a chronic disease.

Cystic fibrosis, Cystic fibrosis in children

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Pseudomethemoglobinemia: a case report and review of sulfhemoglobinemia

Article Abstract:

A case is presented of a girl whose diagnosis was delayed because many oximeters cannot accurately measure certain types of abnormal hemoglobin. Oximeters are used to measure blood gases. The 17-year-old girl had overdosed on several drugs. She had turned blue and an oximeter showed an abnormal level of methemoglobin. This is a form of hemoglobin that cannot carry oxygen. She was treated with the standard treatment, methylene blue, but did not respond. A different oximeter showed that she actually had elevated levels of another abnormal form of hemoglobin, sulfhemoglobin.

Measurement, Blood gases, Methemoglobinemia

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Tuberculosis screening at 2 San Diego high schools with high-risk populations

Article Abstract:

Screening for tuberculosis in schools with high-risk populations can be an effective way of finding and preventing the disease. High risk populations here are defined as high in new immigrants, low income and with poor access to health care. In San Diego, 12.8% of students in one school and 24.1% in another tested positive with tuberculin skin tests. In San Diego, tuberculosis is most prevalent in Latino, Vietnamese and Filipino populations.

Evaluation, Tuberculosis, Medical screening, Health screening, Tuberculosis in children

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