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Doody's Review ServiceReviewer: Ahmad Nusair, MD (Marshall University School of Medicine)
Description: Updating the edition published three years earlier, this book tackles the most commonly encountered infectious processes in the intensive care setting. It provides clinicians with guidance to recognize and treat infections in the ICU while differentiating them from their noninfectious mimics.
Purpose: The book aims to present the most up-to-date knowledge in the field of infectious diseases in the critical care setting. There is no doubt that such information is much needed in this era of heightened awareness of the need to prevent nosocomial infections, identify infections promptly, use antimicrobials judiciously, and, hence, improve clinical outcomes.
Audience: Like the author, who is a renowned authority in infectious diseases in critical care settings, I believe that this book is a great resource for a wide spectrum of clinicians, including residents and fellows (medical and surgical) and attending physicians who have critical care responsibilities (including intensivists, pulmonologists, infectious diseases specialists, surgeons, neurologists).
Features: The book is well organized and encompasses most aspects of infectious diseases in the critical care setting. Among the topics it covers are fever in the ICU (infectious and noninfectious etiologies), specific organ-system related infections and their mimics, specific pathogens and the spectrum of the disease they cause in critically ill patients with an emphasis on multidrug resistant organisms (MDROs), infections in specific patient populations (alcoholic, immunocompromised, or organ transplant), and the proper use of antimicrobials. The tables are particularly useful and easy to read. It would have been more efficient if the book just referenced the tables instead of repeating the same information in the text. Despite the fact that some pictures are of poor quality, they are useful. Among the outstanding chapters are the ones on the causes of fever in the ICU and pneumonia. Managing infections in the ICU is a multidisciplinary process and entails therapeutic interventions not limited to the use of antibiotics, but some chapters fail to address such interventions. For example, in the chapter on sepsis, the author didn't allude to use of steroids and pressors. Some recommendations give the impression that certain issues can be tackled only through one strategy. For example, if a central venous catheter-related blood stream infection is suspected, the catheter should be removed and the tip should be cultured. While that may be the ideal approach, other reasonable methods can be as effective, such as the use of the differential time concept.
Assessment: As an infectious disease specialist who is enroute to specializing in critical care medicine, I found this an excellent resource, both comprehensive and useful. This third edition has expanded its spectrum to include emerging infectious diseases issues. It will be particularly useful for critical care physicians, since critical care books don't give infections their due. For example, The ICU Book, 3rd edition, Marino (Lippincott Williams & Wilkins, 2007), devotes fewer than one-tenth of its pages to review only major infectious processes, and doesn't tackle crucially important issues such as fever in the ICU or mimics of infection.