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Krugman's Infectious Diseases of Children |  |
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Krugman's Infectious Diseases of Children | |
The current edition, named for Krugman, retains the purpose of the original, which was to depict the clinical patterns of childhood infections, explain laboratory diagnosis, and recommend treatment or preventive measures. A classic chapter in the original book, entitled "The Diagnosis of Acute Exanthematous Diseases," emphasized that the practitioner must evaluate the implications of these diagnoses not only for the patient but also for those in close contact and the community. In this edition, the chapters that provide descriptions and illustrations of diseases such as measles are particularly useful, since as a consequence of immunization programs, many pediatricians, including those of us specializing in infectious diseases, have little or no direct experience with their clinical manifestations. Cases must be recognized to achieve rapid control of sporadic outbreaks, such as the recent rubella epidemic in the Northeast. Other chapters explain how exanthems that were of unknown cause in 1958 are attributable to specific agents -- for example, how exanthem subitum is attributable to human herpesvirus 6, erythema infectiosum to parvovirus B19, and infectious mononucleosis to Epstein-Barr virus. Similarly, Lyme disease, caused by Borrelia burgdorferi, must be added to the tick-bite fevers associated with rash.
Like earlier editions, this edition of Krugman's Infectious Diseases of Children should be a useful resource for students. The editors and contributors have accomplished the difficult task of balancing breadth and detail. Several chapters include original diagrams of the typical course of common childhood infections. Some readers might prefer more modern graphics, but these illustrations indicate the "kinetics" of the illness, which is helpful in recognizing the disease in different phases and understanding pathogenesis and immunity. Students can learn what the rash of scarlet fever looks like from the picture of the solemn boy of the 1950s whose photograph educated their predecessors.
General pediatricians will appreciate the chapters about clinical syndromes, such as gastroenteritis and neonatal sepsis. These chapters present information about the many bacterial, viral, fungal, and parasitic agents implicated in each syndrome -- representing 27 distinct pathogens in gastroenteritis, for example -- and provide current recommendations for management. Specialists will value the thorough reviews of new pathogens, notably HIV, and reemerging threats, such as that posed by tuberculosis. In the late 1950s, hospital-acquired infections caused by penicillin-resistant Staphylococcus aureus constituted a new problem. Now, complex protocols for diagnostic evaluation and antimicrobial regimens are necessary to manage infections that may be caused by resistant organisms in hospitalized or chronically ill infants and children, who often have progressive diseases such as cystic fibrosis. Specialists in pediatric infectious disease, other specialists in pediatrics or surgery, and general pediatricians often care for these children together and can share the information provided by experts on these issues.
An appendix catalogs 26 "emerging agents," including HIV, which appears to be a new pathogen in humans, as well as agents recently identified as the cause of recognized illness, such as parvovirus B19, and those not yet associated with any childhood disease, such as human herpesvirus 8. Infectious causes have also been discovered unexpectedly in the case of some syndromes, such as infant botulism. At this pace, the value of this classic textbook is not likely to diminish.
Reviewed by Ann Arvin, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.
