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Infectious diseases detected at autopsy at an urban public hospital, 1996-2001

Lian A Bonds1, Loretta Gaido, Jan E Woods

  • 1Department of Pathology and Laboratory Services, Denver Health Medical Center, Department of Pathology, University of Colorado School of Medicine, Denver, USA.

American Journal of Clinical Pathology
|June 24, 2003
PubMed

Insights

Clinical and autopsy diagnoses for infectious diseases show significant discrepancies. Many infectious disease cases, particularly acute bronchopneumonia in adults and acute chorioamnionitis in neonates, were missed during clinical evaluation.

Area of Science:

  • Pathology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Previous research highlights diagnostic discrepancies between clinical assessments and autopsy findings.
  • However, the specific impact on diagnosing infectious diseases remains under-explored.

Purpose of the Study:

  • To evaluate the concordance between clinical and autopsy diagnoses of infectious diseases.
  • To determine the discrepancy rates for infectious disease diagnoses in adult and pediatric populations.

Main Methods:

  • Retrospective review of 276 patient records (182 adults, 94 fetuses/neonates) undergoing autopsy (1996-2001).
  • Application of the Goldman classification scheme for comparing clinical and autopsy diagnoses.
  • Analysis of infectious disease prevalence and clinical underdiagnosis.

Main Results:

  • Infectious diseases were present in 75.3% of autopsied adults and 48% of fetuses/neonates.
  • Clinical diagnoses missed infectious diseases in 43.1% of adult cases and 58% of fetal/neonatal cases.
  • Acute bronchopneumonia (adults) and acute chorioamnionitis (fetuses/neonates) were the most frequently missed diagnoses.

Conclusions:

  • Substantial discrepancies exist between clinical and autopsy diagnoses of infectious diseases.
  • Improved clinical recognition and diagnostic strategies for infectious diseases are warranted, especially for specific conditions in different age groups.

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