A modern view on diagnostic errors in pulmonary cavitation

DOI: https://doi.org/10.29296/25877305-2021-02-06
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Issue: 
2
Year: 
2021

N. Karpina, MD; R. Asanov; E. Shishkina; A. Egorova, Professor A. Ergeshov, MD Central Research
Institute of Tuberculosis, Moscow

Until now, 100% of the pathognomonic clinical and radiological signs have not been identified for any disease that manifests itself as pulmonary cavitation. In view of the diagnostic errors occurring, their frequency during different pathological processes in the lung varies from 19 to 93.7%. Objective: to analyze the frequency and pattern of diagnostic errors during pulmonary cavitation. Material and methods. Examinations were made in 122 patients with pulmonary cavitation. Under the current conditions, it was established that there was mainly mycobacterial infection (82.8%) during pulmonary cavitation; the pattern of the later showed pulmonary mycobacteriosis (41.0%) along with destructive tuberculosis (41.8%). Using a statistically significant sample of immunocompetent individuals revealed that the frequency of diagnostic errors during pulmonary cavitation amounted to as much as 82% and varied from 60.8 to 100.0% according to the nosological entity of a respiratory disease. Results. Analysis of the frequency and pattern of diagnostic errors in pulmonary cavitation indicated the overdiagnosis of destructive pulmonary tuberculosis (60.7%) and destructive pneumonia (29.7%), which occurs due to the underdiagnosis of pulmonary mycobacteriosis (100.0% of the diagnostic error cases) in regional healthcare facilities. Conclusion. The etiological and/or morphological verification of the diagnosis is necessary to eliminate errors in pulmonary cavitation. In particular, elimination of errors in the diagnosis of pulmonary mycobacteriosis is certain to require the introduction of a serious methodological approach that provides microbiological verification of mycobacteria to species.
Keywords: 
phthisiology
pulmonology
pulmonary cavitation
diagnostic errors
tuberculosis
nontuberculous mycobacteriosis

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