Abstract Successful treatment against infectious agents depends on rapid and accurate detection of the causative organisms. Misdiagnosis can hamper such success while leading to improper advising of antibiotics. In Bangladesh, the majority of the diagnostic centers detect and identify pathogens through culture and biochemical test-based methods and suggest antibiotics based solely on the results of disk-diffusion methods. This pilot study tried to validate the identity of the isolates characterized by diagnostic facilities near Dhaka. One hundred and twenty pre-characterized clinical isolates were analyzed biochemically and genotypically. Random Amplification of Polymorphic DNA-PCR, rcsA, and phoA genes-based PCR, and Loop-Mediated Isothermal Amplification (LAMP)-based identification of Klebsiella pneumoniae and Escherichia coli, respectively, followed by 16S rRNA sequencing confirmed misidentification of some clinical pathogens of other genera as Klebsiella spp. and E. coli. According to the antibiotic susceptibility testing guidelines, antibiotic choice, sensitivity pattern, and breakpoint measurement are different for each group of organisms. The lack of adherence to proper standards results in misdiagnosis and may facilitate the development of antibiotic resistance. The pilot study observers misidentification of clinical pathogens identified by the diagnostic centers. Well-characterized rapid molecular techniques like LAMP are suggested in clinical diagnosis to avoid misdiagnosis and subsequently circumvent antibiotic resistance development.

Congenital Dermatofibrosarcoma Protuberans (DFSP) is an extremely rare low-grade soft tissue sarcoma arising from the dermis. Accounting for less than 0.1% of all malignancies and approximately 1% of soft tissue sarcomas, congenital DFSP presents a significant diagnostic challenge due to its atypical presentation in neonates and infants. Often mimicking benign skin lesions such as hemangiomas, vascular malformations or pigmented moles, it is frequently misdiagnosed, leading to delays in appropriate treatment. This narrative review highlights the importance of early recognition and accurate diagnosis of congenital DFSP to prevent aggressive local growth and reduce the risk of recurrence. We discuss the epidemiology, clinical presentation and diagnostic hurdles associated with this condition. Histopathological examination remains the gold standard for diagnosis, with characteristic findings of spindle-shaped cells in a storiform pattern and strong CD34 positivity on immunohistochemical staining. Imaging modalities such as MRI may be helpful in assessing the extent of the lesion. Surgical excision with clear margins, preferably using Mohs micrographic surgery, is the cornerstone of treatment, balancing oncological control with functional and aesthetic considerations in paediatric patients. A multidisciplinary approach involving dermatologists, paediatric surgeons, oncologists and pathologists is essential for optimal management. We also emphasise the need for clinician vigilance, early biopsy of suspicious lesions, patient education and long-term follow-up to improve outcomes and quality of life for affected children.