title: Doctor's delay in endobronchial tuberculosis.
abstract: 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.
  
  
  METHODS
  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, 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.
  
  
  CONCLUSIONS
  These 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.
authors.affiliation: Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. tamura-in@tokyo-hosp.jp
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tamura
authors.forename: Naoko
authors.initials: N
authors.lastname: Higaki
authors.forename: Kei
authors.initials: K
authors.lastname: Kusaka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Akashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shimada
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawashima
authors.forename: Junko
authors.initials: J
authors.lastname: Suzuki
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Oshima
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Masuda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Matsui
authors.forename: Akira
authors.initials: A
authors.lastname: Yamane
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagai
authors.forename: Naohiro
authors.initials: N
authors.lastname: Nagayama
authors.forename: Emiko
authors.initials: E
authors.lastname: Toyota
authors.forename: Shinobu
authors.initials: S
authors.lastname: Akagawa
authors.forename: Akira
authors.initials: A
authors.lastname: Hebisawa
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Shoji
authors.forename: Ken
authors.initials: K
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis*