Incorrect Initial Diagnosis Research Articles

Lower respiratory tract involvement in Rocky Mountain spotted fever

• A retrospective study of 35 patients with Rocky Mountain spotted fever was undertaken to determine the frequency of respiratory symptoms, as well as to analyze the types of pulmonary problems encountered in hospital patients. Cough, present in only 33% of patients, led to an incorrect initial diagnosis and delay in therapy in eight individuals. Lower respiratory tract involvement (rales, abnormal chest roentgenograms, and abnormal gas exchange) was present in 42% of patients at some point during the illness. The conditions of nine patients deteriorated during the first week of hospitalization. Pulmonary edema (probably noncardiogenic) was the usual explanation for worsening gas exchange. Bacterial pneumonia and hemorrhage were detected in only two patients. (<i>Arch Intern Med</i>140:223-227, 1980)

Lower Respiratory Tract Involvement in Rocky Mountain Spotted Fever

A retrospective study of 35 patients with Rocky Mountain spotted fever was undertaken to determine the frequency of respiratory symptoms, as well as to analyze the types of pulmonary problems encountered to hospital patients. Cough, present in only 33% of patients, led to an incorrect initial diagnosis and delay in therapy in eight individuals. Lower respiratory tract involvement (rales, abnormal chest roentgenograms, and abnormal gas exchange) was present in 42% of patients at some point during the illness. The conditions of nine patients deteriorated during the first week of hospitalization. Pulmonary edema (probably noncardiogenic) was the usual explanation for worsening gas exchange. Bacterial pneumonia and hemorrhage were detected in only two patients.

Malacoplakia of the Prostate Confused with Clear Cell Carcinoma

Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatitis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated.