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Paediatric Infectious Diseases. A Comprehensive Guide to the Subspecialty. By G J Noel, J J Stavola, and V Schauf. (Pp 361; £20 paperback.) Johns Hopkins University Press, 1997. ISBN 0-8018-5564-0.
Is paediatric infectious disease a subspecialty? In the UK this is only true in some tertiary centres. Elsewhere children with infectious diseases are cared for by general paediatricians working with microbiologists. Whatever the arguments for or against subspecialisation, this American book very effectively covers the scope of paediatric infectious diseases and gives a robust and rigorous approach to practice. Written with the general paediatrician in mind, it starts with a concise section on host defence, immunity, and the microbial pathogenesis of infectious disease. Nearly half the book is then devoted to individual pathogens and the diseases they cause. There are excellent diagrams and tables and the background microbiology/virology is described in such a way that the clinical features of each disease are better understood. There is a welcome emphasis on the role of the immune response in disease pathology which further aids understanding of clinicopathological processes. Inevitably there is a lack of detail in places but each section is well referenced and there is full acknowledgment of the debt owed to the standard major textbooks. Much of the latter part of the book consists of an extremely useful section describing infections by organ system; it is logical and clearly presented and gives a good overview. This section will be particularly useful as a quick reference when facing a tricky clinical problem. The chapter on infection in the immunocompromised child is rather sketchy but there are very useful chapters on immunisation, antimicrobial agents, epidemiology, and research design and analysis.
While not a comprehensive textbook, this should prove a helpful clinical handbook, useful for quick reference and for checking whether one is approaching a clinical problem in the right way. It should also give trainees a good framework of the areas of knowledge that need to be covered to gain a thorough and comprehensive understanding of paediatric infectious diseases.