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Updated: Oct 11, 2025

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Errors in Diagnosing Infectious Diseases: A Physician Survey.

Mahboubeh Haddad1, Fereshte Sheybani1, HamidReza Naderi1

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Summary

Diagnostic errors in infectious diseases significantly impact patient outcomes. Upper respiratory tract infections and tuberculosis were most frequently misdiagnosed, with TB and intra-abdominal infections leading to severe consequences.

Keywords:
cognitive biasesdiagnostic errorsinfectious diseasespatient safetysurvey

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Area of Science:

  • Medical Diagnostics
  • Infectious Disease Epidemiology
  • Patient Safety

Background:

  • Infectious diseases are frequently misdiagnosed, leading to adverse patient and community health outcomes.
  • Diagnostic errors in infectious diseases pose a significant challenge in clinical practice.

Purpose of the Study:

  • To investigate common diagnostic errors in infectious diseases.
  • To identify the causes of these diagnostic errors based on physician reports.

Main Methods:

  • A survey was conducted among specialist physicians and residents in Mashhad, Iran, from August 2018 to February 2019.
  • Participants reported diagnosed infectious disease errors they had made or witnessed.

Main Results:

  • 465 cases were reported, with upper respiratory tract infections (URTIs), tuberculosis (TB), and pleuropulmonary infections being most affected by diagnostic errors.
  • Errors most commonly occurred during diagnostic hypothesis generation (55.7%), history taking (43%), and physical examination (41.1%).
  • Diagnostic errors for TB and intra-abdominal infections were associated with more severe patient outcomes.

Conclusions:

  • Diagnostic errors in infectious diseases substantially affect patient outcomes.
  • URTIs, TB, and pleuropulmonary infections are frequently involved in diagnostic errors.
  • Consideration of contagious and life-threatening diseases in differential diagnoses is crucial for improving patient safety.