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Samuel Vaisrub, MD

JAMA. 1975;233(11):1196.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Therapies based on a tentative diagnosis often hinder its confirmation at a later date. Liver or cyanocobalamin given to a patient with suspected pernicious anemia can vitiate subsequent microscopic diagnosis by altering the morphology of the blood and the bone marrow. Thyroid taken by a patient with suspected hyperthyroidism will so change the values of protein-bound iodine and thyroxine as to make their interpretations valueless for diagnostic corroboration.

A particularly rich source of such therapeutically vitiated diagnoses is antibiotic therapy. An antibiotic taken for the treatment of an uninvestigated sore throat can render a throat swab useless should it become necessary to rule out a β-streptococcal infection. A bacteriologic diagnosis of bacterial endocarditis may become impossible after the patient has been treated with antibiotics for a fever as yet undiagnosed. Penicillin taken for the treatment of gonorrhea may suppress the clinical manifestations of a coexistent syphilitic infection.

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