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Cases in Clinical Infectious Disease Practice

Cases in Clinical Infectious Disease Practice

Okechukwu Ekenna

ISBN: 978-1-119-04424-6

Jul 2016, Wiley-Blackwell

272 pages


In the era of cost cutting and lack of adequate health insurance for many patients, clinical skills and time spent with patients are not adequately compensated. Yet, these dwindling and underpaid skills – good history taking, observation of and listening to patients, and physical examination of patients – remain very essential to making and reaching a complete and accurate diagnosis. Expensive laboratory and imaging diagnostics while very relevant, should not replace these age-old skills that have served to enhance and maintain the doctor-patient relationship and human connection, a connection that is often necessary for healing.

Cases in Clinical Infectious Disease Practice uses case studies to illustrate how the infectious disease clinician processes and integrates data to arrive at a diagnosis. This type of hands-on approach, invaluable in training programs, is utilized to take the reader through initial patient encounter, through the history and physical examination, to simple laboratory findings and stains, to a final diagnosis, in a way that is easily accessible to clinicians, students, and laboratory personnel working with clinical specimens.

  • Appeals to practitioners of all levels, with focus on patients with common problems or complications of common infections without heavy technical language
  • Emphasizes basic clinical skills including history taking, observation, epidemiology, and physical exam, as well as simple laboratory tests, explaining how they lead to a reasonable diagnosis
  • Presents cases seen first-hand within the community setting, reflective of cases or situations a resident or student is likely to encounter in the real world after training

Cases in Clinical Infectious Disease Practice is an essential resource for clinicians, graduate and medical school students, and others conducting medical and clinical microbiology or infectious disease research on real patients.

Table of Normal Laboratory Values, ix

About the Author, xi

Dedication, xiii

Acknowledgments, xv

Preface, xvii

Introduction, xix

How the book should be used and understood, xxi

1 Skin and Soft Tissue Infections, 1

Case 1.1 Soft tissue infection following traumatic aquatic exposure, 1

Case 1.2 Soft tissue infection of the hand and wrist in an 81-year-old man, 6

Case 1.3 A 41-year-old Caucasian female with right arm swelling, 12

Case 1.4 A 24-year-old female with fever and arm swelling, 15

Case 1.5 A 72-year-old male with necrotic soft tissue elbow infection, 16

Case 1.6 A 37-year-old man with severe body aches and fever, 18

2 Fever of Unknown Origin and Drug-Induced Fever, 25

Case 2.1 Hypersensitivity masquerading as sepsis, 25

Case 2.2 A psychiatric patient with HIV infection and fever, 32

Case 2.3 A hypertensive patient with 2 months of fever and chills, 36

Brief review and discussion of drug-induced fever, 38

Lessons learned from these two cases, 40

3 Dermatologic Manifestations of Infectious and Non-infectious Diseases, 41

Case 3.1 A 45-year-old patient referred for ""persistent shingles"", 41

Case 3.2 A 39-year-old female with fever and acute rash illness, 46

Case 3.3 A 45-year-old female with subacute rash illness for 2 weeks, 50

Case 3.4 An 82-year-old man with a chronic non-healing elbow wound, 55

4 Diseases Acquired Through Close Contact with Animals, 61

Case 4.1 A 10-month-old child with ""worms"", 61

Case 4.2 Infectious complication of cat scratch, 67

Case 4.3 A young man with acute left arm lymphadenopathy, 72

5 Travel-associated Blood-borne Parasitic Infection, 77

Case 5.1 A 15-year-old adolescent male with fever and thrombocytopenia, 77

Case 5.2 A 23-year-old Caucasian male with fever and chills, 81

Case 5.3 A 57-year-old male with acute-onset fever and chills, 83

Comparison of the characteristics of five patients with malaria seen between 1998 and 2015, 86

6 Gulf Coast Tick Rash Illness, 93

Case 6.1 Woman with rash and prolonged eschar following a tick bite, 93

Case 6.2 A 58-year-old male with generalized body aches and fever, 97

7 Infectious Diseases Associated with Trauma and Outdoor Activities, 103

Introduction, 103

Case 7.1 A 30-year-old man with thumb infection and forearm nodules, 103

Case 7.2 Severe infection and sepsis following recreational fishing, 108

Classification and characteristics of infectious diseases associated with trauma and outdoor activities, 114

8 Acute and Chronic Subcutaneous Fungal Infections, 121

Case 8.1 Exophytic skin lesion masquerading as cancer, 121

Case 8.2 Chronic persistent subcutaneous fungal infection of the leg, 124

Case 8.3 A young man with a laceration injury contaminated with soil, 130

9 Endocarditis with Unusual Organisms or Characteristics, 137

Case 9.1 Man with dyspnea, cough, fever, and weight loss, 137

Case 9.2 Confusing staining characteristics and false identification of a pathogen by automated system in a seriously ill patient, 143

10 Severe Systemic Fungal and Other Infections in AIDS Patients, 153

Case 10.1 HIV patient with progressive shortness of breath, 153

Case 10.2 Recurrent multiorgan infection in an immunocompromised patient, 161

11 Toxic Manifestations of Infectious and Non-infectious Diseases, 171

Case 11.1 An odd presentation for toxic shock syndrome, 171

Case 11.2 A peculiar and dramatic presentation of septic shock, 176

Case 11.3 A 45-year-old woman with rash, hepatitis, and lymphadenopathy, 185

12 Skin and Soft Tissue Infections Seen Post Hurricane Katrina in 2005, 195

Introduction, 195

Case 12.1 A 76-year-old Caucasian female with leg laceration, 195

Case 12.2 A 76-year-old man with rapid-onset cellulitis, 198

Case 12.3 A 61-year-old man with diabetic neuropathy, 200

Case 12.4 A 45-year-old man from a refugee camp with calf laceration, 201

General comments on soft tissue infections in relation to Hurricane Katrina, 202

13 Other Miscellaneous Infections, 211

Case 13.1 A 17-month-old child with facial swelling and adenopathy, 211

Case 13.2 Persistent headache in a 50 year old with known migraine, 217

Case 13.3 A 54-year-old man with skin lesions with central numbness, 223

Case 13.4 Delayed diagnosis in a young woman with migratory joint pain, 231

Index, 241