• Atsuhisa Tamura, Naoko Higaki, Kei Kusaka, Shunsuke Akashi, Junichi Suzuki, Masahiro Shimada, Jun Suzuki, Masahiro Kawashima, Junko Suzuki, Nobuhiro Oshima, Kimihiko Masuda, Hirotoshi Matsui, Akira Yamane, Hideaki Nagai, Naohiro Nagayama, Emiko Toyota, Shinobu Akagawa, Akira Hebisawa, Shunsuke Shoji, and Ken Ohta.
• Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. tamura-in@tokyo-hosp.jp
• Kekkaku. 2013 Jan 1;88(1):9-13.

ObjectiveThe aim of this study was to investigate the current status of doctor's delay in diagnosing endobronchial tuberculosis (EBTB) and to elucidate the risk factors contributing to the delay.MethodsRetrospective clinicopathological analysis.PatientsSixty-two patients with EBTB were admitted at our hospital between 1999 and 2010. Their backgrounds, symptoms, diagnoses at initial consultation, delay in diagnosis, and clinical examination results were analyzed.ResultsOf the 62 patients, 59 had acid-fast, bacillipositive sputum smear test results at admission. Among the 40 patients with total diagnostic delay of more than 2 months, only 11 experienced long patient's delay exceeding 2 months. However, 22 patients experienced long doctor's delay of more than 2 months (28% vs. 55%, respectively, p < 0.05), suggesting that doctor's delay contributes more to total delay than patient's delay. Fever was less frequent in patients with long doctor's delays than in those without (0% vs. 18%, respectively), at the initial consultation. In addition, radiographs showed that patients with long doctor's delays more frequently presented with shadows in the lower lung field (50% vs. 23%, p < 0.05), and most of these patients had noncavitary shadows on admission. All 7 patients diagnosed with bronchial asthma at the initial consultation had long doctor's delays.ConclusionThese findings demonstrate that long doctor's delays in diagnosing EBTB remain an issue. The clinical features of EBTB with long doctor's delays were confirmed to be quite different from those of pulmonary tuberculosis.

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