Twenty-six of the cases without diagnostic delay lacked documentation of CRC screening prior to diagnosis.
In four other women (0.5%), breast cancer was diagnosed after referral in the next screening round for the same lesion that had been considered benign at workup 2 years before; in these cases, the diagnostic delay was 25 27 months.
[ 6] However, in both cases, the diagnostic delay was relatively short compared to previous reports where children and adults who ultimately were diagnosed with malignancy had longstanding bony lesions that were not improving on appropriate antibiotic therapy.
We excluded cases of extrapulmonary tuberculosis, latent tuberculosis, and suspected tuberculosis; cases merely receiving prophylaxis (and hence unlikely to have active tuberculosis); cases for which the diagnostic delay could not be calculated; and cases younger than 16 years.
On the other hand, the study suggests that some environmental risk factors, such as the lack of ventilation associated with the time of exposure, may be crucial for the transmission, aside from the status smear of the index case and the diagnostic delay.
Smear-negative TB in HIV infected cases can be subject to diagnostic delays or incorrect diagnoses due to the absence of clinical features of TB which lead to treatment delays, inappropriate therapies and poor prognoses [ 1, 9- 11].
Clinically, it is always a great challenge to diagnose peritoneal lymphomatosis, and there are several case reports describing the diagnostic delay and confusion.
In migrants the diagnostic delay in cases of active TB is mainly related to the delayed presentation of the patients to the health system [ 28, 29] and it is responsible for the spread of the disease among other members of their community.
Thus, increasing awareness of PID among physicians is needed to reduce the number of undetected cases and to decrease the diagnostic delay.
Points of concern include the proportion of patients lost to follow-up, diagnostic delay, low case detection rate and the continuing high prevalence of HIV.
