Although there are more than 100 known microbial causes of pneumonia, the cause of up to 50 percent of all cases of community-acquired pneumonia requiring admission to the hospital is unknown. This may be because there are pathogens still waiting to be discovered or because of inadequate diagnostic techniques. Pneumonia is an ever-changing disease -- the worldwide spread of penicillin-resistant and, indeed, multidrug-resistant Streptococcus pneumoniae has necessitated a change in our therapeutic approach to pneumonia.
Infectious Diseases of the Respiratory Tract mixes a traditional and a novel approach to this subject. The traditional approach is reflected in the discussion of diagnostic methods, major respiratory tract pathogens, and respiratory tract syndromes. The novel approach is to include a variety of topics such as respiratory tract infections associated with foreign travel, miscellaneous agents of pneumonia and lower respiratory tract infections, and pulmonary infections in patients with cystic fibrosis.
The discussion of pneumonia due to the major respiratory tract pathogens is generally good. The quality of the radiographs is excellent. Some of the chapters, such as those on pulmonary infections in cystic fibrosis, cytomegalovirus pneumonia, legionellosis, and miscellaneous agents of pneumonia and lower respiratory tract infections, make the textbook a worthwhile purchase for the respirologist or infectious-diseases consultant with an interest in pneumonia.
There is, however, no discussion of general issues that challenge the physician who deals with patients with pneumonia: Are there criteria that I can use to decide whom to admit and whom to send home? What is the best empirical therapy for patients who can be treated on an ambulatory basis, especially if I am practicing in an area in which there is penicillin-resistant S. pneumoniae? When do I switch to oral antibiotics? What are the discharge criteria for patients who are admitted with pneumonia? There are also some unavoidable gaps in the textbook, such as the absence of a discussion of the newer "respiratory tract quinolones," and some avoidable lapses, such as the lack of a chapter dealing with nursing home-acquired pneumonia.
Reviewed by Thomas Marrie, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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5.0 out of 5 stars
lower respiratory tract infectino,
By jamil mohd omer (dubie) - See all my reviews
This review is from: Infectious Diseases of the Respiratory Tract (Hardcover)
respiratory infectione. broncitis.pneumonia. any bacterial or virous infection related to respiratory system.
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