Anne Gershon, et al - "Krugman's Infectious Diseases of Children" (0323017568)

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Anne Gershon (Editor), Peter Hotez (Editor), Samuel Katz (Editor),

"Krugman's Infectious Diseases of Children" (11th edition)

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During the first half of the 20th century, the infectious causes of many common childhood diseases became widely understood. The lives of numerous children were saved by improving sanitation, educating parents about hygiene and the communicability of diseases, and immunizing children against diphtheria, pertussis, tetanus, and smallpox. Krugman's Infectious Diseases of Children is the 10th edition of a book by Krugman and Ward first published in 1958 (St. Louis: Mosby). A comparison of the two editions is an occasion to assess progress in the past 40 years. In the light of the achievements of Enders, Weller, Sabin, Salk, and others, Krugman and Ward wrote of living in the golden age of viruses. Although the crisis brought on by the human immunodeficiency virus (HIV) could not have been anticipated, the authors' optimism has been justified by the success of vaccines for poliomyelitis, measles, mumps, rubella, varicella, hepatitis A, hepatitis B, rabies, and rotavirus infection. In contrast to the account in the 1958 edition, the chapter on smallpox and vaccinia in the 10th edition describes the eradication of smallpox by means of a global immunization effort. Progress against bacterial disease is represented by the dramatic impact of Haemophilus influenzae type B vaccine. In therapeutics, penicillin and tetracycline have been joined by more than a hundred other antimicrobial agents for treating childhood infections.

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.

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