Infectious diseases detected at autopsy at an Urban Public Hospital, 1996-2001

• Published in: American journal of clinical pathology Vol. 119; no. 6; pp. 866 - 872
• Main Authors: BONDS, Lian A, GAIDO, Loretta, WOODS, Jan E, COHN, David L, WILSON, Michael L
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.06.2003
• Subjects: Adult; Autopsy; Bacterial Infections - diagnosis; Biological and medical sciences; Bronchopneumonia - diagnosis; Chorioamnionitis - diagnosis; Female; Fetal Diseases - diagnosis; Hospitals, Public; Humans; Infant, Newborn; Infection - diagnosis; Infection - microbiology; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Miscellaneous. Technology; Mycobacterium Infections - diagnosis; Mycoses - diagnosis; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pregnancy; Retrospective Studies; Urban Population; Virus Diseases - diagnosis; Human; Mycosis; Cause of death; Infection; Pathology; Infectious disease; Autopsy; Viral disease; Quality control; Bacteriosis; Clinical investigation; Diagnosis; Comparative study
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/MLUFX0HR5B96GVAX

Previous studies have demonstrated significant discrepancy rates between clinical and autopsy diagnoses. However, infectious diseases have not received emphasis in these studies. We conducted a study to determine whether the clinical and autopsy diagnoses of infectious diseases are concordant or discrepant and to determine discrepancy rates. Retrospective reviews of the records of 276 patients (adults, 182; fetuses and neonates, 94) who underwent autopsy during the years 1996 through 2001 were performed. Comparison of clinical and autopsy diagnoses was performed using the Goldman classification scheme. Of 182 adult patients, 137 (75.3%) had an infectious disease at autopsy. In 59 (43.1%) of 137 patients, the infectious disease diagnoses were unknown clinically. Of 94 fetuses and neonates, 45 (48%) had an infectious disease at autopsy. In 26 (58%) of 45 patients, the infectious disease diagnoses were unknown before death. There are substantial discrepancies between clinical and autopsy diagnoses of infectious diseases. In adults, acute bronchopneumonia is the infectious disease most often missed clinically; in fetuses and neonates, it is acute chorioamnionitis.