Manual of Clinical Problems in Infectious Disease, 5th edition Nelson M. Gantz, Richard B. Brown, Steven L. Berk, and James W. Myers Philadelphia, PA: Lippincott, Williams, & Wilkins, 2004. 574 pp. $49.95 (softcover)

Twenty years ago, as an infectious disease fellow, I purchased the second edition of the Manual of Clinical Problems in Infectious Disease, which was then a 420-page spiral-bound book. At that time, my informal review of the manual revealed a work that was concise, practical, and relevant to the clinical practice of internal medicine and infectious diseases. In fact, I found it so useful that I kept it on my bookshelf for many years. Now, 2 decades later, I find myself in a position to formally review the most recent edition of the same manual, this time from the perspective of a practicing infectious diseases physician.

The fifth edition of the Manual of Clinical Problems in Infectious Disease is a 574-page paperback book (no longer spiral-bound) that appears to have much the same aim as the older edition: to provide a contemporary approach to the diagnosis and treatment of selected infectious disease problems, primarily in adult patients. The intended audience for this work is medical students, house officers, and persons in clinical practice. The book is written by 17 contributors and 4 coeditors and contains 86 chapters (many of which are new), covering a gamut of infectious disease—related topics that range from relatively broad and traditional subjects, such as fever and pleural effusions, to more-specific and current topics, such as West Nile virus, severe acute respiratory syndrome, and bioterrorism. As in the older edition, the text is written in a clear and concise manner with useful, often-annotated, bibliographic references (some of which are as recent as 2004) provided at the end of each chapter. Many chapters also provide Web site addresses of electronic resources that should further expound on the information provided in the book. The text is further enhanced by ample use of tables throughout the book, providing ready access to practical information, such as potential causes of false-negative tuberculin reactions and initial laboratory testing of chronic meningitis.

Unfortunately, the book also has several shortcomings. First, there are occasional, nevertheless significant, inaccuracies and deficiencies in some of the information provided. For example, vancomycin is considered to be “dialyzable” by hemodialysis (chapter 44, p. 265), surgical intervention in the management of severe recalcitrant Clostridium difficile diarrhea is mentioned in neither of the 2 chapters covering this infection (chapters 16 and 73), and no recommendation is made against the empiric use of ciprofloxacin in the treatment of gonorrhea among certain patient populations known (at least since 2003) to be at high risk of contracting quinolone-resistant strains of Neisseria gonorrheae (chapter 24). In addition, although pharyngitis caused by a relatively uncommon infection, diphtheria, is discussed in some detail, the management of a much more frequent clinical situation involving the isolation of “other groupable streptococci” (accounting for 6% of pharyngitis in adults, according to the book) from throat cultures of symptomatic patients with sore throat is ignored. Similarly, there is no mention of the potential use of azithromycin in the treatment of pertussis (chapter 4), an increasingly common infection among adults.

I was also disappointed that the coverage of certain important topics in clinical infectious diseases, such as the management of Staphylococcus aureus bacteremia with or without the presence of indwelling vascular catheters, infections associated with the use of TNF inhibitors, community-acquired methicillin-resistant Staphylococcus aureus infections, and atypical mycobacterial infections appears to have been largely overlooked. I also found occasional inconsistencies in the information provided between certain chapters with overlapping subject matters. For example, pyuria is defined as ⩾10 WBCs per high-power field from a centrifuged specimen in one chapter (chapter 20), but it is defined as ⩾15 WBCs per high-power field in another (chapter 24). Similarly, prophylactic antibiotics and the choice of antimicrobial agents in the care of animal bites are considered to be “controversial” in one chapter (chapter 41) but apparently not in another (chapter 61), in which detailed recommendations for antibiotic prophylaxis following animal bites are included. Also readily evident is the occasional mismatch between chapter titles and section titles. For example, the section entitled “Immunity” curiously contains only a single chapter—"Recurrent Furunculosis"—which is a subject that is usually not associated with any known immunodeficiency, particularly in the era of increasing community-acquired methicillin-resistant S. aureus skin infections. Similarly, the chapter on parvovirus infections was included under the section entitled “Skin and Soft Tissue,” even though the majority of adults with parvovirus B-19 infection do not develop a rash with their illness. Lastly—and this is perhaps a bit petty—the size of the text print in the manual seems to be smaller and lighter than it does in the older edition, placing unnecessary strain on the eyes of those of us whose visual acuity has not improved with age.

These pitfalls notwithstanding, this manual serves as a potentially useful resource and a quick reference for clinicians and physicians-in-training who regularly encounter infectious disease problems. However, the reader is well advised to use this book only as an “appetizer” and not as the “main entrée” (i.e., use it as a springboard for further learning and not as the final guide for the diagnosis and management of infectious diseases).

Acknowledgments

Potential conflicts of interest. F.A.M.: no conflicts.

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