PART 1: INTRODUCTION 1
The nature of the practice of infectious diseases 1
Components of a diagnosis 1
Microbiological diagnosis 2
Risk factors for infection 2
Methods for making a microbiological diagnosis 3
Principles of management of patients with infectious diseases 5
Principles of choosing antimicrobial therapy 8
Principles of addressing public health interests 10
PART 2: CLINICAL CASE EXERCISES 12
1. A teenage girl with nausea and abdominal pain 12
2. An 18-month-old child with fever, cough, and red eyes 17
3. An infant with runny nose, cough, and rapid breathing 24
4. A neonate with fever and cerebrospinal fluid pleocytosis 26
5. A 5-year-old boy with a limp 30
6. A teenage boy with sore throat and fever 34
7. A teenage boy with fever, headache, and bleeding 39
8. A teenage boy with agitation and altered level of consciousness 42
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9. A 6-year-old girl with a rash 44
10. A 12-year-old girl with fever and rapid breathing after renal transplantation 55
11. A 4-year-old boy with fever after heart surgery 58
12. A 6-year-old girl with sickle cell disease and worsening anemia 59
13. A 5-year-old girl with walking difficulty and speech deterioration 61
14. A 6-month-old boy with poor feeding, fever, and lethargy 63
15. A 2-year-old boy with recurrent hospitalizations for fever and cough 67
16. A neonate with a rash 69
17. A 6-year-old girl with weakness and muscle pain 72
18. A 48-year-old man with fever and multiorgan failure 75
19. A 6-month-old boy with diarrhea and fever 77
20. An 18-month-old girl with fever and a rash 87
21. A neonate with eye discharge 92
22. A 9-year-old boy with joint pain and swelling 94
23. A 3-year-old boy with eyelid swelling 97
24. A 6-year-old boy with fever and sore throat 99
25. A premature neonate with skin spots and ankle swelling 101
26. A 3-year-old boy with fever, confusion, and a rash 104
27. A 6-month-old girl with fever and altered level of consciousness 105
28. A neonate with failure to use one limb 110
29. A 6-month-old child with a ventriculoperitoneal shunt and fever 112
30. A 1-day-old infant with respiratory distress and shock 112
31. An 8-month-old infant with fever and shock 114
32. An infant, recovering from pneumonia, with a facial abnormality 117
33. A picture of an abnormal 5-day-old infant 119
34. A 10-year-old girl with a sore throat after returning to the United States
from Odessa 120
35. A 2-week-old neonate with fever and altered mental status 123
36. A 5-year-old girl with recurrent episodes of fever, cough, and chest pain 124
37. An 8-year-old boy with cough, chest pain, and fever after bone marrow
transplantation 125
38. A 4-month-old infant with constipation and floppiness 127
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39. A 15-year-old Turkish shepherd with a sore on his arm 130
40. A 10-year-old girl with previous severe infections, presenting with leg swelling
and pain 131
41. Pictures of several infants 0–3 months old with the same diagnosis 133
42. A 13-year-old boy with repeated episodes of fever 137
43. A triathlete with fever and headache 139
44. A 13-year-old boy with knee pain 141
45. A 12-year-old girl with abdominal pain 143
46. An 18-month-old boy with fever and rash 146
47. A 24-year-old man with headache, fever, and rash 149
48. A 13-year-old girl with eye pain 151
49. An 18-month-old boy with a limp and fever 153
50. A 3-year-old South African boy with fever and abdominal pain 154
51. A 1-month-old infant with jaundice 157
52. A 12-year-old girl with fever and abdominal pain 158
53. A 16-year-old boy with a bad cough 159
54. A 10-year-old boy with fever and an axillary swelling 162
55. A 6-month-old infant with fever and irritability 163
56. A 12-year-old boy who develops fever and hypotension while in the
intensive care unit 165
57. A 10-year-old girl with recurrent episodes of pneumonia 166
58. A 4-year-old boy with fever and diarrhea 168
59. A 2-year-old boy with fever and purple skin lesions 171
60. A 13-year-old boy with thalassemia, presenting with fever and hypotension 172
61. A 3-old boy with fever for 1 month and abdominal tenderness 174
62. A physician with abdominal discomfort and diarrhea 177
63. A 6-year-old boy with fever 181
64. An 18-year-old hunter with fever and lymphadenopathy 189
65. A 4-month-old infant with strabismus and developmental delay 191
66. An 8-year-old girl with seizures 194
67. A 10-year-old boy with hematuria 198
68. A 3-year-old girl with respiratory difficulty and fever 202
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69. A 16-year-old Mexican boy with fatigue 203
70. A 6-year-old Liberian girl with a cutaneous ‘‘cyst’’ 205
71. An 18-month-old boy with a worm 207
72. A 2-year-old boy with altered mental status 209
73. An 18-month-old child, receiving treatment for tuberculosis, with respiratory
difficulty 215
74. An 11-year-old boy with AIDS, presenting with weight loss and fever 220
75. A 2-year-old boy with suspected tuberculosis 223
76. A 12-year-old boy with long-standing neck pain 225
77. An 18-month-old boy with fever, rash, and red eyes 228
78. A 5-year-old boy with shortness of breath 231
79. An 8-year-old boy with fever, cough, weight loss, and fatigue 233
80. A 9-year-old boy with a neck swelling 237
81. A 10-month-old boy, hospitalized for kwashiorkor, who develops fever 240
82. A 2-year-old boy with AIDS and skin lesions 242
83. A toddler with fever and abdominal pain 244
84. A 2-year-old girl with cough and fever 246
85. An 18-month-old girl with fever and vomiting 253
86. An 11-year-old boy with fever, headache, and confusion 255
87. A 6-year-old South African boy with fever, abdominal pain, and pallor 257
88. An 18-month-old girl with fever and neck swelling 260
89. A 17-year-old boy with back pain, incontinence, and leg weakness 262
90. An 18-month-old girl with fever and inability to move her neck 263
91. A 2-year-old boy with fever and a limp 266
92. A neonate with petechiae and hepatosplenomegaly 268
93. An 18-month-old boy with fever, respiratory difficulty, and grunting 269
94. A 5-year-old boy with unilateral facial swelling 271
95. A 2-year-old girl with abdominal pain and refusal to walk 273
96. An 8-month-old infant with meningitis refractory to therapy 274
97. A 10-year-old boy with progressive infection 275
98. A 17-year-old girl with development of renal failure during treatment for a
vascular catheter infection 277
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99a. A 3-year-old boy with a ventriculoperitoneal shunt infection who develops
a seizure 278
99b. A 10-year-old boy with asthma who develops a seizure 279
99c. A 17-year-old girl with tuberculosis, presenting with nausea and vomiting 279
100. An 11-year-old Mexican girl with a painful, swollen knee 281
101. A very ill neonate with abdominal distension 284
102. A 6-year-old South African shepherdess with abdominal discomfort 287
103. A 9-year-old girl with fever, rash, and joint pain 291
104. A 21-year-old woman with fever, shock, and skin lesions 293
105. A 17-year-old boy with fever, rash, and headache after a South African
safari 300
106. A 10-year-old girl with a skin problem 303
107. A 5-year-old girl with recurrent episodes of fever 304
108. A 14-year-old boy with fever and hip pain 305
109. A 10-year-old boy with abdominal pain during treatment for meningitis 308
110. A 4-year-old boy with autoimmune lymphoproliferative disorder who develops
a sore throat 310
111. A 16-year-old boy with fever, headache, muscle aches, and weakness 311
112. A 4-year-old boy with an eye injury complicated by infection 313
113. A 12-year-old boy with nephrotic syndrome who develops abdominal pain and
fever 315
114. An 18-month-old girl with stridor 316
115. A 15-year-old girl with abdominal pain 319
116. A 12-year-old boy with fever, cough, and pallor 323
117. A 6-year-old girl with meningitis 325
118. A 13-year-old girl with fever, headache, and depressed level of
consciousness 326
119. A 12-year-old girl, living in a rural area, with fever and respiratory
difficulty 329
120. A 12-year-old boy with a sore throat, fever, and poor perfusion 331
121. A 6-year-old girl, being treated for an epidural abscess, with persistent
fever 334
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PART 3: APPENDIX 336
Table A1. Infectious diseases reportable in the United States 336
Table A2. Taxonomy of human pathogens, their ususal sources, and the main
