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A pseudoepidemic of postoperative scleritis due to misdiagnosis
D R Burwen1, C E Margo, M M McNeil
1Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia, USA.
Objective:
To describe a pseudoepidemic of infectious scleritis following eye surgery.
Methods:
Retrospective cohort study with selected procedural and laboratory investigations.
Results:
Twenty-one patients with postoperative scleritis were identified during a 2-month outbreak. Neither an infectious etiology nor a causative pre-, intra-, or postoperative exposure was found. The clinical findings, when carefully reviewed, were consistent with poor surgical-wound closure.
Conclusions:
The art of clinical diagnosis involves the subjective interpretation of clinical history, physical findings, and laboratory results. A repeated error in the interpretation of clinical findings can simulate an outbreak of disease. Clinicians may be reluctant to concede misdiagnosis.