Book Review

Pediatric Infectious Diseases: Principles and practice

N Engl J Med 1996; 334:475-476February 15, 1996

Article

Pediatric Infectious Diseases: Principles and practice
Edited by Hal B. Jenson and Robert S. Baltimore, with Richard I. Markowitz and A. Brian West. 1593 pp., illustrated. Norwalk, Conn., Appleton and Lange, 1995. $175. ISBN: 0-8385-2474-5

The publication of another major textbook on pediatric infectious diseases reflects the continuing growth of a subspecialty whose existence has recently been validated by the American Board of Pediatrics with the establishment of certification for its practitioners and a professional organization, the Pediatric Infectious Disease Society. Infectious diseases are so common in children that knowledge of this field continues to be of major importance for pediatricians and family-medicine physicians. The editors, Drs. Jenson and Baltimore, have acknowledged this point in their objective: this book should be “a practical and useful resource for both consultants in pediatric infectious diseases and primary care physicians.” In many respects, the editors have succeeded admirably.

The book is syndrome-oriented and thus avoids the duplication and inconsistencies of a traditionally organized infectious-disease textbook. When appropriate, each chapter follows a standard format of subsections on epidemiology, pathogenesis, symptoms and clinical manifestations, diagnosis, treatment, prognosis, and prevention. This consistent framework helps the reader find information rapidly. The editors have deliberately omitted references, instead providing in each chapter a brief list of reviews and key articles for further reading (as is the case with many other medical textbooks). Some contributors, however, have included major citations to support key points.

The scope of the book is broad and comprehensive. Many of the 64 contributors are recognized authorities, and others, judging from the quality of their chapters, are likely to be. The book is generally well written and, for the most part, marked by clarity and conciseness. It contains current information, including discussions of very recent developments such as vaccines licensed in early 1995 (when the book went to press).

Some chapters are noteworthy for their detailed, clinically oriented presentations of information that is not readily found elsewhere. Examples include the chapters on infections acquired abroad, which affect travelers, immigrants, and refugees, and the chapter on diagnostic imaging by the book's consulting radiologist. A consulting pathologist also participated in the preparation of the book, indicating the editors' recognition of the importance of these disciplines in the diagnosis of pediatric infectious diseases. The chapters on anti-infective therapy, immunizations, and evaluation of immune function are other examples of the many excellent contributions in this book. The informative tables and figures are hallmarks of the book and will contribute to its usefulness in practice and teaching in the field of pediatric infectious diseases. These summaries and guides, especially those concerning differential diagnoses, disease categories and features, and management, are not often found in other textbooks to the extent that they are in this book.

Like most first editions the book does have some deficiencies. A major one is that the index is not as comprehensive as I desired (although with a little imagination I could find the specific topics on which I was seeking more information). The cross-referencing is inadequate because references are often made to chapters rather than specific sections or page numbers. Another limitation is the lack of references, which precludes pursuing questions in greater detail or verifying an author's viewpoint. I and a fellow in pediatric infectious diseases whom I asked to use this book as a reference for several months while we were working together on a consultation service arrived independently at these conclusions. Given that the purpose of the book is to be a practical, clinically oriented reference for primary care physicians and subspecialists, the occasional detailed discussions of the molecular biology of pathogenesis seem unnecessary. Some chapters are more detailed than others, creating a degree of inconsistency that probably reflects the conflict in a book intended for both primary care physicians and subspecialty consultants. This criticism is minor, however, since the comprehensiveness of the book is impressive. I could find only one major omission, a chapter on epidemiology. A review of modes of transmission, principles of epidemiologic investigation, and common statistical methods and terms of analysis, such as sensitivity, specificity, odds ratio, and relative risk, would have been useful.

This book is an excellent addition to the armamentarium of physicians caring for children with infectious diseases. It does not always provide the depth — and thus serve as a definitive reference — that specialists might desire, but this aspect is understandable in view of the editors' goal of a book useful for primary care physicians and subspecialists. Although it may not be the only textbook to which specialists in pediatric infectious diseases will refer, those who use it will find it a welcome addition to their libraries.

Georges Peter, M.D.
Brown University School of Medicine, Providence, RI 02903