Unsuspected Infectious Diseases and Other Medical Diagnoses in the Evaluation of Internationally Adopted Children

Abstract

Seven simple screening tests—hepatitis B profile, urine culture for cytomegalovirus, Mantoux test for tuberculosis, stool examination for ova and parasites, VDRL, complete blood cell count, and vision and hearing screening—were used to evaluate 52 consecutive children at a pediatric clinic for international adoptees. In 63% of these children, unsuspected medical diagnoses were made by a combination of history, physical examination, and appropriate screening tests. When only those children previously examined by a physician in the United States were included in our analysis, the rate of unsuspected diagnosis remained high (67%). Omission of screening tests was the single most frequent cause of missed diagnoses, of which the majority were infectious diseases. More than 50% of our newly established diagnoses carried the potential for long-term sequelae without proper treatment. These data emphasize that internationally adopted children should receive a thorough screening evaluation for medical problems that may adversely affect their growth and development.