[Diagnostic errors in the treatment of patients with pleural diseases]

As illustrated by analysis of 342 case histories, none of 280 patients admitted for two years to the Center for Diagnosis and Treatment of Pleural Diseases had the verified admission diagnosis. Missed diagnosis was possible because the physicians in charge had not prescribed pleural puncture, tomography of the lungs and mediastinum after maximal removal of the exudate. Other causes were inadequate investigation of the pleural fluid, administration of antibacterial therapy and glucocorticoids in obscure diagnosis. Poor diagnosis of pleural disease reflects the absence of clear-cut policy of management of such patients as a result of which in general practice pleural diseases are detected 2 weeks after visit to a doctor, on the average. To the specialized center the patients are sent only 47 days after the disease onset. Specialists of the center make differential diagnosis with early use of needle biopsy of the pleura which enables to reduce the time of making diagnosis to 10-12 days.