10 Mistakes Most Often in Children Diagnosis

KOMPAS.com - Enforcing a disease diagnosis by a physician is often not as easy as imagined. Several different abnormalities or diseases often manifest clinical signs and symptoms of the same. Thus, in some cases frequently occur "wrong diagnosis" or overdiagnosis or misdiagnosis of an illness when a person is not suffering.

Error diagnosis or wrong diagnosis means that a person is given a specific diagnosis but it is actually not necessarily have the disorder. Not only in Indonesia, it is also common overseas. The terms and conditions are almost similar fall termed pit diagnosis, overdiagnosis or misdiagnosis.
Many factors why it happens often. A major factor is in some diseases in determining the gold standard or to make a clinical diagnosis or a disease just by observing history of the disease and disease manifestations. While diagnostic tools such as laboratory tests or other investigations are not expected as much specificity and sensitivity are not too good so often lead to false positives or false negatives.
This means that an error occurred in laboratory tests that should be examined when the results are negative but positive, and vice versa. In addition to the accuracy of the tool is not good common misinterpretation of the results of laboratory assessments.
Here are 10 of the most common overdiagnosis, especially in young children:
1. Cow's milk allergy.
Determining the verdict child is allergic to cow's milk is not as easy as imagined. Not all manifestations of allergy must be caused by an allergy to cow's milk. The cause of allergy to cow's milk is only about 2-3% range, but the fact that nearly all children who experience allergic symptoms, often direct diagnosis of cow's milk allergy. Many babies are allergic to cow's milk initially diagnosed and advise me to drink milk that expensive. Apparently when the evaluation turns out the child is not allergic to milk sap had another case when o-6 months of age to drink cow's milk but no problems at age 7 months was sentenced to cow's milk allergy.
Indeed to convicting a cow's milk allergy is not that easy. To determine patients who have been convicted of cow's milk allergy is the main option extensive hydrolyzate milk or soya. Often errors occur that every child has the signs and symptoms of allergy to cow's milk allergy and sentenced advise me partial hydrolyzate milk allergy. In fact, milk is only for the prevention or prophylaxis for children at risk of allergic or not allergic to cow's milk allergy sufferers.
Ensuring cow's milk allergy is not easy because in certain circumstances such as allergy tests skin tests or blood tests can not tell. Standard gold standard or cow's milk allergy should ensure the elimination chalenge test or provocation. This makes often happens overdiagnosis or difference of opinion among the doctors in determining sentencing cow's milk allergy in children or infants. Allergens when examined too often triggered by a viral infection and is caused due to dust allergies or other food allergies.
2. Bacterial infection.
Other frequent misdiagnosis is a viral disease was diagnosed as a bacterial infection. Infectious disorders vomiting, vomiting, diarrhea, fever, cough, runny nose or other acute infections are mostly caused by a viral infection that does not require antibiotics. But the fact that there are mostly going overdiagnosis or overtreatment. Many such cases are given antibiotics which should not be given antibiotics.
3. Dust allergy.
Any dust that are most often recognized as the cause of complaints of cough, colds, sinusitis prolonged. Actually, the main cause of dust allergies are dust home or "house dust". Dust outside the home is rarely considered as a cause of allergy. Even many parents think that cough and cold berkepanjngan due to building projects around the house.
When observed dust that had been considered as the culprit allergen may be questioned. It can be proven that allergic complaints such as coughs and colds often occur during the night and early morning. And during the night and early morning dust less. Allergic reactions because dust is a rapid reaction that should occur when more activity during the day time.
Other facts also been many parents who have to clean all the dust, dolls, carpets and fitted AC Plasmacluster but apparently allergic cough and cold symptoms do not go away. Even the Swedish study suggests the use of carpet declined, but instead use menaingkat lantaeas allergy sufferers increased rapidly. Dust may be cause allergies when in large numbers such as when entering the barn, the house is not occupied more than a week, when loading and unloading the room or when sweeping or when wearing or taking stuff that has been stored in a shed or closet a long time.
Disorders due to dust including rapid reaction usually does not last long, so exposure to the dust is gone, in a few moments complaints will disappear. If the disorder is certainly long slow reaction, the situation like this seem to often be suspected food allergies. Causes and triggers of allergies that often is a viral infection or flu it is often unrecognized allergy sufferers.
4. ADHD.
Many cases children can not sit still, impaired concentration and emotional disorders as ADHD but not convicted. Many normal children also have menifestai not be silent, distraction and disruption in the shapes emosimeski weight. Normal condition is common in people with allergies to digestive disorders salran. ADHD diagnosis is wrong in the United States.
5. Typhoid fever.
Often a person diagnosed with typhoid fever by more than 2-4 times a year when they are not suffering from the disease. Typhoid misdiagnosis often occurs because of the specificity of the results of laboratory tests of blood or the examination widal typhoid IgG and IgM are not good. Often occurs positf false or dengue virus infection. So often occurs as well as people convicted of typhoid fever due to typhoid positive laboratory results are not yet suffering from typhoid. Reaction false positive laboratory results typhoid often occurs in people with allergies or hipersenitif as highly reactive antibody reactions often lead to errors laboratory results.
6. Tuberculosis.
Definitive diagnosis of TB is difficult because of the discovery of the child Micobacterium tuberculosis (M.TBC) as the cause of TB in children is not easy. So often misdiagnosed in the enforcement of diagnosing TB in children. Consequences that must be addressed is the provision of multidrug (2 or 3 different types of antibiotics) within a period of 6 months. The provision of anti-TB drugs in children who do not have TB than cause unnecessary expenses, also the risk of side effects such as drug delivery liver disorders, ear innervation, blood disorders, and so on.
In society there is a tendency even some clinicians signs and symptoms are not specific TB in children is often used to provide basic TB treatment in children. Though many other diseases that have symptoms. Failure to thrive or weight does not go up, feeding difficulties, recurrent fever, frequent coughing or enlarged lymph nodes around the neck and the back of the head is non-specific symptoms in children. But it seems that in everyday practice this disorder often immediately suspected TB symptoms.
Should these symptoms can be caused by several other diseases. Disturbances are also often experienced by people with allergies, asthma, gastrointestinal disorders, and other disorders in children. Signs and symptoms of TB are unspecific very similar to other diseases. Disruption failed to grow and nonspecific airway disorders often experience overdiagnosis of tuberculosis. Disease or asthma and allergy sufferers who fail to grow with difficulty eating most often considered the same because the symptoms of TB disease.
7. Cold allergy.
Symptoms of sneezing, coughing, runny nose are often diagnosed as allergic prolonged cold. Actually cold is merely the trigger or aggravate rather than a cause. This means that if there is no other allergens that despite the cold will not cause any complaints. Cold or air-conditioning is often considered the ringleader cause. But this opinion is not entirely true because a lot of people with allergies coughing during nap with AC very cold cough symptoms. It is still not known why allergy or asthma symptoms often occur at night. Suspected role of hormonal sirkadial phenomenon resulting symptoms during the night and early morning hours are more common. Demkikian also when examined cold allergy sufferers sentenced to one day old tinggal.beberapa dent very cold even lived in Europe for a few months during the winter colds and batukjustru complaint cured.
8. Pnemoni.
People with asthma or bronchial hipersnsitif or hypersensitive airways is often diagnosed as a lung infection or pnemoni raucous but merely common acute respiratory infections. This occurs because of an error in the reading of x-ray interpretation. In patients with respiratory allergies and asthma often menampkkan splotches like lung infkesi pnemoni is not. Infiltrates or pulmonary infections radiological spotting subtle sedangakan common in people with asthma are more rugged, two different Although this is often mistaken by doctors radiologipun. So that the treating physician would necessarily follow that robtgen reading results when clinical manifestations are not in accordance with such pnemoni no sign crackles smooth wet and crowded.
9. Appendix.
Severe abdominal pain is often diagnosed appendicitis abdominal pain but can also occur in many cases. Sometimes frequent overdiagnosis of appendicitis because the symptoms that occur about the same quality and location of pain with other disorders. Usu misdiagnosis deadlock often occurs in people with allergies or asthma who previously had a history of colic as a baby, often fussy when aged under the age of 3 months or recurrent abdominal pain.
10. Hirschsprung Disease.
Several cases of people with difficult defecation in infants often experience overdiagnosis as Hirschsprung disease. Hirschsprung disease is a disorder that is difficult bowel movements caused by the absence of ganglion innervation of the colon or in the area around the anus. This disorder must be confirmed by biopsy and had surgery to remove most of the colon.
Some people convicted as Hirschsprung disease as based on barium examination photo and had to do surgery. Dilalkukan second opinion before surgery to other doctors and made the elimination of several food allergens apparently bowel disorders such difficulties can be improved without surgery. Difficult defecation disorders much one factor often associated with food allergic disorders.
Impact and prevention
Impact of error diagnosis happens when this happens is sometimes mild to fatal. The impact of other light is a very large expense such costs when not actually have allergies to cow's milk but recommended special hypoallergenic milk that cost up to several times over. Another effect, which should not take medicine but antibiotics should be given antibiotics.
Data in Growup Clinic Jakarta indicate that fault diagnosis is most often affects people with asthma, allergies and gastrointestinal hypersensitivity. Data show that nearly more than 90% of patients who undergo overdiagnosis occurs in people with asthma, allergies and gastrointestinal hypersensitivity. Apparently allergies can interfere with all bodily systems and has many clinical manifestations often resemble other diseases.
The best way to do this is for people with an allergy when diagnosed 10 diseases as mentioned above should be more careful diagnosis procedures by using carefully observe history of the disease, signs and symptoms of the disease and the interpretation labatorium good. Physicians should carefully interpret laboratory results.
There should not be treating patients just by looking at the laboratory without clinical manifestations of patients. Some common laboratory tests false positive or negative results but the results should be positive.
When the diagnosis is in doubt, a second opinion should be done or a second opinion to another doctor. In the event of fault diagnosis, often with errors of therapy and treatment.
Sources: http://health.kompas.com/read/2013/01/07/05593051/