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Fast Facts: Respiratory Tract Infection, Second Edition FREE TO VIEW

Miguel E. Pellerano, MD
Chest. 2005;127(2):693-694. doi:10.1378/chest.127.2.693-a
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Published online


Robert C. Read and Donald E. Craven. Oxford, United Kingdom: Health Press Limited, 2003; 126 pp; $108.00

There is growing interest in the diagnosis and management of respiratory tract infections for a number of compelling reasons. First, pneumonia is the sixth-leading cause of death in the United States; second, it is the leading cause of death from infectious diseases. In addition, pneumonia generates much interest and controversy in terms of definition, diagnostic approach, and treatment. Finally, hospital-acquired pneumonia, and ventilator-associated pneumonia (VAP) in particular, has long been the object of great scrutiny as the second-most-common nosocomial infection and the leading cause of death from hospital-acquired infections.

Respiratory Tract Infection is small in size, concise, and its layout is practical, such that physicians, nurses, and medical students will find the information easily accessible. The information provided bridges the gap between theory and patient care while maintaining an excellent focus on etiologic pathogens and therapy. It does not cover pathogenesis, diagnostic approach, or radiologic findings at great length, nor are there details of less common infections such as fungal disease. However, it serves as a guide to current clinical practice, and deals with newly described respiratory pathogens, emerging antibiotic resistance, difficulty in reaching a rapid diagnosis so as to guide treatment, and the high morbidity and mortality associated with improper selection of therapy. This new edition also includes a chapter on bioterrorism causing pulmonary diseases, serving to remind us of an emerging threat that needs to be part of our differential diagnosis.

The first part of the book discusses community-acquired and hospital-acquired pneumonia with an emphasis on etiology, clinical features, risk factors, and assessment of severity using both the pulmonary severity index and the clinical pulmonary infection score as applied to the diagnosis of VAP. The authors cautiously provide recommendations on the use of bronchoscopy, blind BAL, protected-brush specimens, as well as quantitative endotracheal aspirates in patients with VAP.

The common clinical scenario of COPD exacerbation is covered, including the results of different trials assessing the effect of empiric antibiotics use on outcome. Also, the chapter on tuberculosis focuses on newer, rapid diagnostic tests, recent guidelines for the management of tuberculosis, multidrug resistant tuberculosis, and latent infection. This section also contains an explanation of the process of tuberculin testing in the United Kingdom using the Heaf test. Simple and essential information regarding differential diagnosis, use of diagnostic testing, and therapy concerning pneumonia in the immunocompromised host is also included.

In summary, Respiratory Tract Infection accomplished its objective, serving as an excellent practical resource for health-care workers. This text is very well suited to the general internist, resident, and medical student. It may also be of use to the specialist, especially with respect to guiding empiric therapy in order to cover specific pathogens.




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