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Infectious Diseases in Critical Care Medicine

612 Pages · 2009 · 5.83 MB · English

  • Infectious Diseases in Critical Care Medicine

    Infectious


    Diseases in


    Critical Care


    Medicine


    Cunha_978-1420092400_TP.indd 1 10/5/09 4:21:18 PM INFECTIOUS DISEASE AND THERAPY


    Series Editor


    Burke A. Cunha


    Winthrop-University Hospital


    Mineola,NewYork


    and


    StateUniversity ofNewYorkSchoolof Medicine


    StonyBrook,NewYork


    1. ParasiticInfectionsinthe CompromisedHost,editedby Peter D.WalterandRobert


    M. Genta


    2. Nucleic Acid and Monoclonal Antibody Probes: Applications in Diagnostic Method-


    ology, edited by Bala Swaminathan and Gyan Prakash


    3. Opportunistic Infections in Patients with the Acquired Immunodeficiency Syndrome,


    edited by Gifford Leoung and John Mills


    4. Acyclovir Therapy for Herpesvirus Infections, edited by David A. Baker


    5. The New Generation of Quinolones, edited by Clifford Siporin, Carl L. Heifetz, and


    John M. Domagala


    6. Methicillin-Resistant Staphylococcus aureus: Clinical Management and Laboratory


    Aspects, edited by Mary T. Cafferkey


    7. Hepatitis B Vaccines in Clinical Practice, edited by Ronald W. Ellis


    8. The New Macrolides, Azalides, and Streptogramins: Pharmacology and Clinical


    Applications, edited by Harold C. Neu, Lowell S. Young, and Stephen H. Zinner


    9. Antimicrobial Therapy in the Elderly Patient, edited by Thomas T. Yoshikawa and


    Dean C. Norman


    10. ViralInfectionsoftheGastrointestinalTract:SecondEdition,RevisedandExpanded,


    edited by Albert Z. Kapikian


    11. Development and Clinical Uses of Haemophilus b Conjugate Vaccines, edited by


    Ronald W. Ellis and Dan M. Cranoff


    12. PseudomonasaeruginosaInfectionsandTreatment,editedbyAldonaL.Battchand


    Raymond P. Smith


    13. Herpesvirus Infections, edited by Ronald Glaser and James F. Jones


    14. Chronic Fatigue Syndrome, edited by Stephen E. Straus


    15. Immunotherapy of Infections, edited by K. Noel Masihi


    16. Diagnosis and Management of Bone Infections, edited by Luis E. Jauregui


    17. DrugTransportinAntimicrobialandAnticancerChemotherapy,editedbyNafsikaH.


    Georgopapadakou


    18. NewMacrolides,Azalides,andStreptograminsinClinicalPractice,editedbyHarold


    C. Neu, Lowell S. Young, Stephen H. Zinner, and Jacques F. Acar


    19. Novel Therapeutic Strategies in the Treatment of Sepsis, edited by David C.


    Morrison and John L. Ryan


    20. Catheter-Related Infections, edited by Harald Seifert, Bernd Jansen, and Barry M.


    Farr


    21. ExpandingIndicationsfortheNewMacrolides,Azalides,andStreptogramins,edited


    try Stephen H. Zinner, Lowell S. Young, Jacques F. Acar, and Harold C. Neu


    22. Infectious Diseases in Critical Care Medicine, edited by Burke A. Cunha 23. NewConsiderationsforMacrolides,Azalides,Streptogramins,andKetolides,edited


    by Stephen H. Zinner, Lowell S. Young, Jacques F. Acar, and Carmen Ortiz-Neu


    24. Tickborne Infectious Diseases: Diagnosis and Management, edited by Burke A.


    Cunha


    25. Protease Inhibitors in AIDS Therapy, edited by Richard C. Ogden and Charles W.


    Flexner


    26. Laboratory Diagnosis of Bacterial Infections, edited by Nevio Cimolai


    27. Chemokine Receptors and AIDS, edited by Thomas R. O’Brien


    28. Antimicrobial Pharmacodynamics in Theory and Clinical Practice, edited by Charles


    H. Nightingale, Takeo Murakawa, and Paul G. Ambrose


    29. Pediatric Anaerobic Infections: Diagnosis and Management, Third Edition, Revised


    and Expanded, Itzhak Brook


    30. ViralInfectionsandTreatment,editedbyHelgaRuebsamen-Waigmann,KarlDeres,


    Guy Hewlett, and Reinhotd Welker


    31. Community-Aquired Respiratory Infections, edited by Charles H. Nightingale, Paul


    G. Ambrose, and Thomas M. File


    32. Catheter-RelatedInfections:SecondEdition,editedbyHaraldSeifert,BerndJansen,


    and Barry Farr


    33. AntibioticOptimization:ConceptsandStrategiesinClinicalPractice(PBK),editedby


    Robert C. Owens, Jr., Charles H. Nightingale, and Paul G. Ambrose


    34. Fungal Infections in the Immunocompromised Patient, edited by John R. Wingard


    and Elias J. Anaissie


    35. Sinusitis: From Microbiology To Management, edited by Itzhak Brook


    36. Herpes Simplex Viruses, edited by Marie Studahl, Paola Cinque and Toms


    Bergstro¨m


    37. Antiviral Agents, Vaccines, and Immunotherapies, Stephen K. Tyring


    38. Epstein-Barr Virus, edited by Alex Tselis and Hal B. Jenson


    39. Infection Management for Geriatrics in Long-Term Care Facilities, Second Edition,


    edited by Thomas T. Yoshikawa and Joseph G. Ouslander


    40. Infectious Diseases in Critical Care Medicine, Second Edition, edited by Burke A.


    Cunha


    41. Infective Endocarditis: Management in the Era of Intravascular Devices, edited by


    John L. Brusch


    42. Fever of Unknown Origin, edited by Burke A. Cunha


    43. Rickettsial Diseases, edited by Didier Raoult and Philippe Parola


    44. Antimicrobial Pharmacodynamics in Theory and Clinical Practice, Second Edition,


    edited by Charles H. Nightingale, Paul G. Ambrose, George L. Drusano, and Takeo


    Murakawa


    45. Clinical Handbook of Pediatric Infectious Disease, Third Edition, Russell W. Steele


    46. Anaerobic Infections: Diagnosis and Management, Itzhak Brook


    47. Diagnosis of Fungal Infections, edited by Johan A. Maertens and Kieren A. Marr


    48. AntimicrobialResistance:ProblemPathogensandClinicalCountermeasures,edited


    by Robert C. Owens, Jr. and Ebbing Lautenbach


    49. Lyme Borreliosis in Europe and North America, edited by, Sunil Sood


    50. Laboratory Diagnosis of Viral Infections, Fourth Edition, edited by Keith R. Jerome


    51. Infectious Diseases in Critical Care Medicine, Third Edition, edited by Burke A.


    Cunha Infectious


    Diseases in


    Critical Care


    Medicine


    Third Edition


    Edited by


    Burke A. Cunha


    Winthrop-University Hospital


    Mineola, New York, USA


    State University of New York School of Medicine


    Stony Brook, New York, USA


    Cunha_978-1420092400_TP.indd 2 10/5/09 4:21:18 PM InformaHealthcareUSA,Inc.


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    LibraryofCongressCataloging-in-PublicationData


    Infectiousdiseasesincriticalcaremedicine/editedbyBurkeA.


    Cunha.–3rded.


    p.;cm.— (Infectiousdiseaseandtherapy;51)


    Includesbibliographicalreferencesandindex.


    ISBN-13:978-1-4200-9240-0(hardcover:alk.paper)


    ISBN-10:1-4200-9240-5(hardcover:alk.paper) 1. Nosocomial


    infections.2. Criticalcaremedicine.3. Intensivecareunits.


    I.Cunha,BurkeA.II.Series:Infectiousdiseaseandtherapy;51.


    [DNLM:1. CommunicableDiseases—diagnosis.2. Communicable


    Diseases—therapy.3. CriticalCare.4. Diagnosis,Differential.5.


    IntensiveCareUnits. W1IN406HMNv.512009/WC100I41652009]


    RC112.I45952009


    616.900475—dc22


    2009022304


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    Marie


    Peerless wife and mother,


    Provider of domestic peace and tranquility,


    Paragon of truth and beauty,


    Paradigm of earthly perfection . . .


    With gratitude for her love and constant support. Foreword


    In the United States during the 1950s, the development of mechanical ventilation led to the


    organization of special units in hospitals, where health care personnel with specific expertise


    could efficiently focus on patients with highly technical or complex needs. Over the ensuing


    years the sickest patients as well as those needing mechanical ventilation were grouped into


    special care units. In 1958, Baltimore City Hospital developed the first multidisciplinary


    intensive care unit. The concept of physician coverage 24 hours a day, seven days a week


    became a logical approach to providing optimal care to the sickest, most complex patients.


    Now,50years afterthefirstmultidisciplinary intensive careunitwasopened,there are


    now 5000 to 6000 intensive care units in the United States: Over 4000 hospitals offer one or


    more critical care units, and there are 87,000 intensive care unit beds. Critical care represents


    13.3% of hospital costs, totaling over $55 billion per year.


    Healthcareprovidersarewellawareoftherolethatinfectionsplayintheintensivecare


    unit. A substantial number of patients are admitted to the intensive care unit because of an


    infectionsuchaspneumonia,meningitis,orsepsis.Asubstantialnumberofpatientsadmitted


    to intensive care units for noninfectious disorders develop infections during their stay. Thus,


    intensivists need expertise in the diagnosis, treatment, and prevention of infectious diseases.


    Management of infections is pivotal to successful outcomes.


    In this third edition of Infectious Diseases in Critical Care Medicine, Burke Cunha has


    organized31chaptersintoanexceedinglypracticalandusefuloverview.Providersoftenfind


    itsurprisinglydifficulttodistinguishinfectiousandnoninfectioussyndromes,especiallywhen


    patients have life-threatening processes that evoke similar systemic inflammatory responses.


    PartIandPartIIprovidemanyclinicalpearlsthathelpwithdiagnosisandwithdevelopinga


    strategy for initial patient management. Specific chapters focus on special intensive care unit


    problems, such as central venous catheter infections, nosocomial pneumonias, endocarditis,


    and Clostridium difficile infection. Particularly useful are chapters on special populations that


    many clinicians rarely encounter: tropical diseases, cirrhosis, burns, transplants, or tubercu-


    losis. Chapters on therapy also provide practical advice focused on critically ill patients, in


    whomchoiceofagent,toxicities,druginteractions,andpharmacokineticsmaybesubstantially


    different from patients who are less seriously ill.


    Critical care medicine is becoming more and more technology based. Genomics and


    proteomics can predict susceptibility to various diseases and drug metabolic problems.


    Patients can be assessedby ultrasonography to supplement physical examination. Diagnostic


    biopsiescanbeperformedonvirtuallyanyorgan.Invasivearterialandvenousmonitoringas


    well as monitoring of central nervous system and cardiac activity is commonplace.


    Despite these advances in technology, knowledge of differential diagnosis, natural history,


    and therapeutic options is still essential. To understand these processes, Burke Cunha has


    assembled an impressive team of experienced clinicians to provide insight into the infectious


    challengesofcriticalcaremedicine.Thiseditioncontinuestoproviderelevant,currentinformation


    thatwillenhanceclinicalpracticewiththisgrowingsegmentofhospitalizedpatients.


    Henry Masur


    Department of Critical Care Medicine


    Clinical Center


    National Institutes of Health


    Bethesda, Maryland, U.S.A.


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