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编号:11305109
Medical Management of Infectious Disease
http://www.100md.com 《新英格兰医药杂志》
     This book was written "for those providing primary care," including subspecialists, and it deals with infections "encountered in the outpatient setting" in adults. The editor has selected a niche for the book and has thereby avoided the question of whether there is a need for another textbook of infectious diseases, given the current availability of several excellent textbooks in this discipline. With the current emphasis on treating as many patients as possible on an outpatient basis, the arrival of a textbook that deals with infectious diseases in an ambulatory setting is indeed timely. I expected that the book would emphasize common infections managed in an outpatient setting and that it would provide clear guidelines for deciding when patients require hospitalization. For the most part, the book accomplishes these goals.

    The book is divided into four sections: an introductory section consisting of nine chapters, a second section that deals with clinical syndromes, a third section that addresses infections in special hosts, and a final section, consisting of three chapters, on health maintenance (including postexposure prophylaxis, adult immunization, and combating bioterrorism). The excellent blend of history and basic science in the chapter entitled "Fever" makes the book a worthwhile purchase.

    The chapter entitled "Infections of the Oral Cavity" is especially well written. This area is often not covered well in reference books about infectious diseases, even though oral infections and lesions are frequent reasons for referral for outpatient infectious-disease consultations. One topic in which there are substantial variations in practice is the decision whether to admit patients with community-acquired pneumonia to the hospital. The chapter on community-acquired pneumonia deals with this question rather superficially and indicates that the pneumonia-severity score (with a few exceptions) should be used to guide the decision. However, this score was developed as a predictor of mortality, and most investigators now believe that it is unsuitable as a guide to decisions about admission.

    Each chapter has one or more tables that refer to points made in the text. It is unfortunate that the choice of dark shading to highlight these sections makes them hard to read. Omissions and overlaps in subject matter are minor. There is some overlap between the chapter on blood cultures and the one entitled "The Clinician and the Microbiology Laboratory." In the chapter entitled "Infections in the Patient with Animal Contact," the author does not mention that cats can be a reservoir for Q fever. Infections resulting from fish bites or the handling of fish receive very little attention, with the exception of the observation that Vibrio carchariae has been recovered from patients who have been bitten by sharks.

    In conclusion, this book will be useful to a variety of clinicians who deal with infectious diseases in an ambulatory setting. The infectious-disease consultant will find sections of the book helpful but will still require traditional reference textbooks in this specialty.

    Thomas J. Marrie, M.D.

    University of Alberta

    Edmonton, AB T6G 2B7, Canada

    tom.marrie@ualberta.ca(Edited by Christopher Gra)