Book Review

Infectious Diseases

N Engl J Med 2000; 342:1843-1844June 15, 2000

Article

Infectious Diseases
By Donald Armstrong and Jonathan Cohen, with others. Approximately 2000 pp. in two volumes, illustrated. St. Louis, Mosby, 2000. $295. ISBN: 0-7234-2328-8

Do we really need another textbook on infectious diseases? This was my first thought as I began to review Infectious Diseases, edited by a team of experts in the field.

This book differs in several aspects from other major textbooks of infectious diseases. The first difference is the liberal use of color. Not only are there many excellent clinical photographs in color, but also the tables, figures, and the last centimeter of each page are color-coded so that specific sections of the book can be identified. In addition, the color photographs illustrate many of the rashes and other cutaneous signs of a variety of diseases that must be recognized by the clinician.

Another unique feature of this book is the section entitled “Practice Points.” There are 53 of these scattered throughout the book. These practice points deal with common, but often troublesome areas in infectious diseases. The authors have carefully chosen these topics and picked an expert to answer what is usually a vexing clinical question. The discussant not only gives advice based on the literature, but also uses personal expertise to solve the particular clinical problem. Some of the perplexing questions that are covered are whether intravascular catheters should be removed, when to perform lumbar puncture and what tests to order in conjunction with the procedure, when to use antibiotics for pharyngitis and otitis media, when to use corticosteroids for tuberculosis outside the central nervous system, how to manage persistent postinfectious diarrhea, how long osteomyelitis should be treated, how to manage chronic infection in prosthetic joints, and what treatment should be given to a pregnant woman with a positive test for toxoplasma.

The book contains eight sections that cover all the major areas of infectious diseases. To assess the value of the textbook to an infectious-disease consultant, I looked up problems that I encountered during three recent weeks on the infectious-disease consultation service. I obtained all the information that I needed to answer each of the following questions. My first question was how botulinum antitoxin should be given, and the book included a clear description of what to do. My next question dealt with meningoencephalitis after the administration of meningococcal vaccine. There was an excellent discussion of the problem of vaccine-associated adverse events. Subsequent questions involved the appropriate length of treatment for mucormycosis involving the lung, the optimal management of cytomegalovirus infection after organ transplantation, the appropriate therapy for candiduria in a patient in the intensive care unit, and the management of tetanus. Each of the topics was dealt with extremely well.

The following topics either were not dealt with adequately or were not mentioned: treatment of nocardia infection, nephropathy related to infection with the human immunodeficiency virus, cellulitis in an intravenous drug user, and linezolid as a treatment option for vancomycin-resistant enterococci. The section on blood-culture–negative endocarditis offered no advice on treatment. The discussion of cystic fibrosis was excellent, but there was no discussion of what to do for patients who were infected with microorganisms that were resistant to all available antibiotics. The latter situation is not uncommon in clinical practice, and this would have been a perfect topic for discussion in one of the practice points. There is an excellent chapter on Lyme disease, but essentially nothing on Rocky Mountain spotted fever.

This book would be a useful addition to the library of any infectious-disease consultant, and the practice points sections alone justify the purchase of the book despite its deficiencies. All will find the illustrations helpful, and reading all of the practice points will provide a working knowledge of many of the common infectious-disease problems.

Thomas Marrie, M.D.
University of Alberta, Edmonton, AB T5G 2B7, Canada