Book Review

Infectious Disease in Emergency Medicine

N Engl J Med 1993; 329:1433November 4, 1993

Article

Infectious Disease in Emergency Medicine
Edited by Judith C. Brillman and Ronald W. Quenzer. 951 pp., illustrated. Boston, Little, Brown, 1992. $150. ISBN: 0-316-10838-3

For the past third of a century, some of the greatest strides in medicine have been made in the area of infectious diseases. The number of causative agents identified and the development of antibiotics have been phenomenal. These achievements gave us a false sense of victory over infections only to see it overturned as infectious agents returned with a vengeance, beginning with legionella and culminating in the AIDS pandemic.

The past third of a century also witnessed the development of emergency medicine as the newest specialty and the most exciting to appear in a long time. As a new area of endeavor, emergency medicine developed rapidly, although the lack of a physician-patient relationship and the sudden, episodic, and unplanned nature of visits to the emergency room, with the necessarily limited data base, have made it very difficult to deal with infections in the emergency setting.

Now come Judith Brillman and Ronald Quenzer with their new book, Infectious Disease in Emergency Medicine. This book is well organized, well constructed, and well written. The book is organized into three distinct parts. Part 1 discusses principles of infectious disease and how to deal with it in the emergency department. In part 2, diagnostic problems are brought forth as they affect the emergency physician. The third part is a more traditional discussion of the cause, diagnosis, and treatment of specific infectious diseases according to organ system.

References from periodicals and textbooks are reasonably up to date and appropriately used. The accompanying color photographs and black-and-white illustrations and tables are informative, well designed, and clearly printed.

Some topics will be particularly useful for the emergency physician: diagnostic tests for infection; the selection of antibiotics on the basis of concentration, fever, and lymphadenopathy; and diabetic foot infections. One chapter deals with the infections of patients with animal and insect contact, and interestingly enough, there is even brief coverage of such noninfectious but tangentially related problems as scromboid, ciguatera, and other marine-toxin poisonings. Some other useful chapters cover infection in infants, the elderly, HIV-positive patients, substance abusers, and travelers and immigrants; parasitic infestations; and dental infections. There are many useful tables, including a complete listing of the addresses of state health departments for the purpose of reporting infectious diseases and receiving information.

The text is multiauthored; however, good editorial control and a fair degree of uniformity have been maintained. There is minimal duplication of material and the book is very attractive.

I believe that this book will be very useful to practicing emergency physicians, residents in emergency medicine, and practically anybody else who frequently encounters patients with infections in an emergency or outpatient setting.

George Podgorny, M.D.
2115 Georgia Ave., Winston-Salem, NC 27104