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Published on: March 1, 2011
Fake imported tropical diseases: A retrospective study
A Romero-Alegría, M Hernandez Cabrera, V Velasco-Tirado
1Moncef Belhassen-García, Servicio de Medicina Interna. Unidad de Enfermedades Infecciosas. CAUSA. IBSAL. CIETUS, Universidad de Salamanca. Paseo San Vicente 58-182, 37007, Salamanca Spain. mbelhassen@hotmail.com.
Objective:
When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay.
Methods:
A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain.
Results:
We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease.
Conclusions:
Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.
Insights
When evaluating suspected imported diseases, consider autochthonous causes to prevent misdiagnosis. This study found cancer in one-third of patients with autochthonous diseases, emphasizing a comprehensive diagnostic approach.
Area of Science:
- Internal Medicine
- Tropical Diseases
- Diagnostic Challenges
Background:
- Evaluating patients with suspected imported diseases requires careful consideration of local (autochthonous) conditions.
- Misdiagnosis and treatment delays can occur if autochthonous diseases mimicking imported pathologies are overlooked.
Purpose of the Study:
- To analyze cases where imported diseases were suspected but autochthonous conditions were diagnosed.
- To highlight the importance of a comprehensive diagnostic strategy in internal medicine, particularly in tropical disease settings.
Main Methods:
- A retrospective, descriptive longitudinal study was conducted.
- Patients were selected from two internal medicine practices specializing in tropical diseases in Spain (2008-2017).
- Focus was on patients initially suspected of having an imported disease but ultimately diagnosed with autochthonous processes.
Main Results:
- 16 patients were included; 11 (68.7%) were male, mean age 43.4 years.
- 13 patients (81.2%) were travelers, with origins from Latin America, Africa, and Asia.
- Diagnoses included autochthonous infection (31.2%), cancer (31.2%), inflammatory disease (12.5%), and vascular disease (12.5%).
Conclusions:
- Travel history can be misleading when diagnosing autochthonous diseases, potentially causing diagnostic delays.
- Cancer was a significant finding (31.2%) among autochthonous diseases in this cohort.
- A comprehensive approach by internists, especially those specializing in infectious/tropical diseases, is crucial for accurate diagnosis.
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