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The Second Edition is an invaluable compilation of clinical experience on the diagnosis and treatment of infectious diseases in critical and intensive care units. Emphasizing differential diagnostic approaches rather than therapy, this reference presents information required by clinicians as they evaluate patients with these conditions-providing authoritative sections on specific clinical syndromes and antibiotic selection.
- Sales Rank: #6413813 in Books
- Published on: 2006-09-15
- Original language: English
- Number of items: 1
- Dimensions: 1.41" h x 7.30" w x 10.00" l, 1.10 pounds
- Binding: Hardcover
- 664 pages
From The New England Journal of Medicine
The demand for increasing accountability with respect to the cost of health care has escalated pressure on physicians to manage an increasing fraction of their patients' illnesses in the outpatient setting. Primary care physicians, in conjunction with an expanding health care team, now provide diagnostic evaluations and treatment for patients with increasingly complex health problems outside the hospital. As a consequence, patients who do require hospitalization are extremely sick. One can envision that with progressive advances in outpatient care, many of our acute care hospitals will consist almost entirely of wards of intensive care or step-down units capable of providing cardiopulmonary monitoring and support for patients with multiple-organ failure.
Moreover, as a result of impressive improvements in supportive care in the intensive care unit, very sick patients are surviving the acute phase of their illnesses. Simultaneously, the microbial world has mounted creative counteroffensives by becoming increasingly resistant to antibiotics (e.g., vancomycin-resistant enterococcus). This, together with the rising prevalence of the human immunodeficiency virus and the emergence of such pathogens as ehrlichia and human herpesvirus 6, makes Infectious Diseases in Critical Care Medicine a welcome addition to the medical literature.
This multiauthored book has four main sections ("General Concepts," "Clinical Syndromes," "Special Problem Areas," and "Therapeutic Considerations") and 43 chapters. It is a useful compilation of information about diverse problems concerning infectious diseases in the intensive care unit. Certain reviews, such as those on infections after neurosurgery, nosocomial pneumonia, infective endocarditis, febrile neutropenia, and resistance to antibiotics, are well written and designed to promote evidence-based practice. The chapter on the mechanisms of antibiotic-induced release of endotoxins is articulate and provocative. The four chapters on noninfectious mimics of infectious syndromes in the intensive care unit are helpful reminders that there may be alternative diagnoses. Many pearls, derived from the editor's extensive experience in infectious-disease consultation and presented in the first overview chapter, will benefit the reader. The judicious use of tables to summarize concepts will be particularly helpful on teaching rounds.
Certain contributions, such as those on nosocomial diarrhea and sepsis associated with infections of the urinary tract, are too brief and mainly cite review articles rather than primary data. Despite an excellent review of the physical examination, the chapter describing objective diagnostic signs in critically ill patients strays a bit from the focus on infectious disease. There is also a tendency to use unexplained abbreviations, such as BOOP (bronchiolitis obliterans organizing pneumonia) and SRMD (stress-related mucosal damage), which makes certain sections less accessible to the nonspecialist. A surprising number of typographic errors have survived the editing process. Perhaps of more concern are the occasional sweeping generalizations that are insufficiently supported by evidence and may be misleading.
In the setting of an aging population of patients with a growing number of coexisting illnesses and with the increased ability of medical personnel to provide cardiopulmonary supportive care, the importance of infectious diseases in the intensive care unit will increase. Infectious Diseases in Critical Care Medicine, by filling a gap in the literature and compiling selected critical reviews, is appropriate for the bookshelves of all physicians with the privilege of caring for critically ill patients.
Reviewed by Brian W. Christman, M.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
Many pearls, derived from the editor's extensive experience in infectious-disease consultation are presented.Infectious Diseases in Critical Care Medicine, by filling a gap in the literature and compiling selected critical reviews, is appropriate for the bookshelves of all physicians with the privilege of caring for critically ill patients.
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