Misdiagnosis of parasitic infection can occur when a finding is mistaken for a parasite. An example was the misinterpretation of epithelial inclusions in the mucosa of the gallbladder as Cystoisospora belli (nee Isospora belli). Accurate diagnosis often involves avoiding the pitfalls along the path.
Histologic finding: inclusions within mucosal epithelial cells of the gallbladder
Failures in the diagnostic process:
(1) failure to consider an alternative diagnosis
(2) failure to conduct confirmatory testing (immunoperoxidase, molecular, etc) or to consult an appropriate specialist
(3) failure to question the diagnosis in the presence of red flags (in this case the occurrence in immunocompetent patients)
(4) lapses in knowledge about the appearance and life cycle of the parasite
(5) becoming enamored with the diagnosis
A misdiagnosis could have been avoided if any one of the failures had not occurred.
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