title: Unsuspected infectious diseases and other medical diagnoses in the evaluation of internationally adopted children.
abstract: Seven simple screening tests--hepatitis B profile, urine culture for cytomegalovirus, Mantoux test for tuberculosis, stool examination for ova and parasites, VDRL, complete blood cell count, and vision and hearing screening--were used to evaluate 52 consecutive children at a pediatric clinic for international adoptees. In 63% of these children, unsuspected medical diagnoses were made by a combination of history, physical examination, and appropriate screening tests. When only those children previously examined by a physician in the United States were included in our analysis, the rate of unsuspected diagnosis remained high (67%). Omission of screening tests was the single most frequent cause of missed diagnoses, of which the majority were infectious diseases. More than 50% of our newly established diagnoses carried the potential for long-term sequelae without proper treatment. These data emphasize that internationally adopted children should receive a thorough screening evaluation for medical problems that may adversely affect their growth and development.
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis.
authors.forename: M K
authors.initials: MK
authors.lastname: Hostetter
authors.forename: S
authors.initials: S
authors.lastname: Iverson
authors.forename: K
authors.initials: K
authors.lastname: Dole
authors.forename: D
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000300:Adoption / Q000592:standards; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis*; D003955:Diagnostic Tests, Routine; D006801:Humans; D007223:Infant; D007391:International Cooperation; D011314:Preventive Health Services; D014481:United States