Fatal undiagnosed tuberculosis in hospitalized patients

Thirty-seven cases of active tuberculosis were misdiagnosed in Chaim Sheba Medical Center in the years 1964-1974. The diagnosis was made only after death. Twenty-one patients were over 60 years of age. Eleven had hematological disorders, and 12 received steroids (sometimes with immunosuppressive or cytotoxic drugs). Misdiagnosis of miliary tuberculosis is a growing problem and demands special attention. The postmortem examination must be systematic and must include bacteriological and histological studies for establishment of the correct diagnosis.