The Clinical and Public Health Consequences of Delayed Scabies Diagnosis: A Systematic Review of Associated Complications
Notice bibliographique
Résumé
Introduction : Scabies, a parasitic infestation caused by Sarcoptes scabiei, is a neglected tropical disease with significant global morbidity. Diagnostic delays, stemming from its varied clinical presentation and mimicry of other dermatoses, are common and suspected to be a primary driver of severe complications. This review systematically evaluates the association between delayed or incorrect diagnosis of scabies and adverse patient and public health outcomes. Methods : A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for observational studies, case series, and outbreak reports published from January 2000 to May 2024. Studies were included if they provided data linking delayed or misdiagnosed scabies to specific clinical, psychological, or public health complications. Data on study design, population, diagnostic delay, and outcomes were extracted. The methodological quality of observational studies was assessed using the Newcastle-Ottawa Scale. A narrative synthesis of the evidence was performed due to the heterogeneity of the included studies. Results : The synthesis included 17 studies involving thousands of patients and numerous institutional outbreaks. A significant association was found between diagnostic delay and multiple severe outcomes. The median time to correct diagnosis in severe cases was 3 months. Misdiagnosis rates were consistently high, frequently reported between 43% and 45%. Key complications strongly linked to diagnostic delay included: progression to crusted scabies, often precipitated by inappropriate corticosteroid treatment. secondary bacterial superinfections with Staphylococcus aureus and Streptococcus pyogenes, severe systemic sequelae including bacteremia, sepsis, post-streptococcal glomerulonephritis, and acute rheumatic fever and large-scale institutional outbreaks, with delayed diagnosis of an index case being the primary catalyst. Prolonged infestation was also correlated with significantly impaired quality of life, sleep disturbance, and psychological distress. Discussion : The evidence demonstrates that delayed diagnosis is not merely a temporal issue but a critical determinant of scabies-related morbidity and mortality. It transforms a treatable skin condition into a catalyst for life-threatening infections, systemic disease, and costly public health crises. The common iatrogenic pathway, where misdiagnosis leads to corticosteroid use and subsequent development of hyper-infestive crusted scabies, highlights a critical vulnerability in clinical practice. Conclusion : Timely and accurate diagnosis of scabies is paramount. Enhanced clinical suspicion, particularly in high-risk populations and individuals with atypical presentations, is essential to prevent severe complications and mitigate the substantial health and economic burden of this globally neglected disease.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,094 | 0,099 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,013 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,002 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».