title: [Delay in the diagnosis of tuberculosis].
abstract: In five patients, a 46-year-old Surinamese man, a 45-year-old Dutch barkeeper, a 41-year-old woman from Eritrea, and an 18-year-old Afghan woman and her 43-year-old mother, tuberculosis was diagnosed and treated after a considerable delay. Such a late diagnosis and subsequent treatment is not uncommon for tuberculosis as the symptoms, physical examination, laboratory tests, imaging techniques and bacteriological results are often not very specific. However under certain circumstances, tuberculosis (including the extrapulmonary manifestations) should be considered at an earlier stage, especially among certain risk groups such as the homeless, drug addicts, immigrants and asylum seekers. In the five patients discussed the causes of delay were identified as: delay caused by the asymptomatic phase of the disease, the patient's delay in presenting, a delay on the part of the physician, a delay in diagnostic confirmation and a delay in the treatment.
authors.affiliation: Gemeentelijke Gezondheidsdienst Rotterdam e.o., afd. Tuberculose-bestrijding, Postbus 70.032, 3000 LP Rotterdam. vanhestr@ggd.rotterdam.nl
authors.forename: N A
authors.initials: NA
authors.lastname: van Hest
authors.forename: G
authors.initials: G
authors.lastname: de Vries
authors.forename: P J
authors.initials: PJ
authors.lastname: van Gerven
authors.forename: H W
authors.initials: HW
authors.lastname: Baars
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance; D012036:Refugees; D012307:Risk Factors; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents