DOCTOR S DELAY IN ENDOBRONCHIAL TUBERCULOSIS

Objective) The 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. (Methods) Retrospective clinicopathological analysis. (Patients) Sixty‑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. (Results) Of the 62 patients 59 had acid‑fast bacilli‑ positive 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 fi eld (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. (Conclusion) These fi ndings demonstrate that long doctor s delays in diagnosing EBTB remain an issue. The clinical features of EBTB with long doctor s delays were confi rmed to be quite different from those of pulmonary tuberculosis.