{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:42:52Z","timestamp":1778935372356,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2011,12,6]],"date-time":"2011-12-06T00:00:00Z","timestamp":1323129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>A negative sputum smear from a patient with history, physical examination, and chest x-ray findings suggestive of tuberculosis (TB) presents a diagnostic dilemma. We investigated the possible factors associated with a misdiagnosis and inappropriate treatment of TB among such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We reviewed the records of 193 patients whose diagnoses with TB included conflicting test results and were reported to the Taiwan Centers for Disease Control in 2004. When other conditions were found to underlie the initial abnormal chest x-ray finding, the diagnosis was revised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      was isolated from sputum samples in 72 of 193 patients (37%), nontuberculous mycobacteria from 4 (2%), and no bacteriologic evidence of\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      from 117 (61%). The initial diagnosis of TB was revised for 26 (13.5%) patients. Patients with positive\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      culture had a lower incidence of revised diagnoses (4.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) than those negative for mycobacterial culture (17.1%) and those with nontuberculous mycobacteria (75%). Chest cavitations in this study were not a significant predictor of revised diagnosis (odds ratio 0.30,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      An incorrect diagnosis of TB despite a negative sputum smear result is more likely to be made for patients positive for nontuberculous mycobacteria culture and less likely for patients with positive\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      culture.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.01454","type":"journal-article","created":{"date-parts":[[2012,1,12]],"date-time":"2012-01-12T08:18:29Z","timestamp":1326356309000},"page":"753-757","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Factors Associated With Misdiagnosis of Smear-Negative Tuberculosis: An Experience in Taiwan"],"prefix":"10.1177","volume":"57","author":[{"given":"Chih-Yun","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Yongkang Veterans Hospital, and the Department of Occupational Safety and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"How-Ran","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, National Cheng Kung University, Tainan, Taiwan."},{"name":"Sustainable Environment Research Center, and the Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Yun","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruay-Ming","family":"Huang","sequence":"additional","affiliation":[{"name":"Hualien Hospital, Department of Health, Executive Yuan, Hualien City, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,12,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.5.1455"},{"key":"e_1_3_2_3_2","volume-title":"Global tuberculosis control: surveillance, planning, financing: WHO report 2007","author":"World Health Organization","year":"2007","unstructured":"World Health Organization. Global tuberculosis control: surveillance, planning, financing: WHO report 2007. Geneva: World Health Organization; 2007.."},{"key":"e_1_3_2_4_2","volume-title":"Statistics of communicable diseases and surveillance report","author":"Centers for Disease Control of Taiwan","year":"2004","unstructured":"Centers for Disease Control of Taiwan. Statistics of communicable diseases and surveillance report. Republic of China: CDCT; 2004, 2005, and 2007.."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.95.6.1193"},{"key":"e_1_3_2_6_2","volume-title":"Global tuberculosis control: surveillance, planning, financing: WHO report 2008","author":"World Health Organization","year":"2008","unstructured":"World Health Organization. Global tuberculosis control: surveillance, planning, financing: WHO report 2008. Geneva: World Health Organization; 2008.."},{"issue":"8131","key":"e_1_3_2_7_2","first-page":"1361","article-title":"Sputum-smear-negative pulmonary tuberculosis: controlled trial of 3-month and 2-month regimens of chemotherapy","volume":"1","year":"1979","unstructured":"Sputum-smear-negative pulmonary tuberculosis: controlled trial of 3-month and 2-month regimens of chemotherapy. Lancet, 1979; 1(8131):1361\u20131363..","journal-title":"Lancet"},{"issue":"11","key":"e_1_3_2_8_2","first-page":"1393","article-title":"Quantitative differences in sputum smear microscopy results for acid-fast bacilli by age and sex in four countries","volume":"13","author":"Rieder HL","year":"2009","unstructured":"Rieder HL, , Lauritsen JM, , Naranbat N, , Katamba A, , Laticevschi D, , Mabaera B. Quantitative differences in sputum smear microscopy results for acid-fast bacilli by age and sex in four countries. 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