Pneumonia is one of the most frequently encountered clinical conditions in the hospital and in the ambulatory setting. Given pneumonia's wide variability in etiology, it is not surprising that challenges exist in every aspect of pneumonia management, from considerations of diagnosis, epidemiology, and evaluation to prevention and treatment. In this third edition of Pneumonia Essentials, Cunha, who is chief of the division of infectious diseases at Winthrop University Hospital, Mineola, New York, presents a concise and practical guide to pneumonia overall, including the major categories of community-acquired pneumonia, nursing home-acquired pneumonia, nosocomial (hospital-acquired) pneumonia, tuberculosis, chronic pneumonias, and pneumonias in the immunocompromised host.
The text is organized in a fairly straightforward manner, beginning with a 20-page overview of pneumonia. There are 17 chapters, each of which includes an outline. The placement of the table of contents on the back cover is a nice touch for ease of use. The section on pneumonia clues is particularly well written and organized, with the differential diagnosis presented several ways, such as by symptoms, laboratory findings, infiltrate location, and patient subsets, to name a few. There is an entire chapter on the sputum Gram-stain, complemented by figures of 6 major pneumonia organisms on Gram-stain on the inside front cover. The bulk of the book contains detailed information about each category of pneumonia.
In keeping with the intended use of the book as a concise guide, there are several tables, throughout the body of the book, on the microbiology, epidemiologic considerations, and therapeutic considerations of each pneumonia category. Some chapters are better written than others. For example, the chapters on nursing home pneumonia and ventilator-associated pneumonia are somewhat simplistic. In contrast, another topic of considerable complexity, community-acquired pneumonia in immunocompromised hosts, is well presented and a wealth of information is nicely summarized.
The book contains an extensive chest radiograph atlas with well put together differential diagnosis tables for several radiographic presentations of pneumonia, including, among others, a focal infiltrate, solitary pulmonary nodule, and multiple infiltrates. The pearls and pitfalls section is organized by organism, with relevant clinical tips presented in short sections for ease of reference.
It is important to note that this book is not intended to provide an in-depth analysis of any particular aspect of pneumonia management. For example, there is very little discussion of pathophysiology, and the sections on prevention are quite scant. The evidence base behind the recommendations is not often discussed or emphasized. However, each chapter has references and suggested reading for users who wish to get more detailed information.
The last section is devoted to antimicrobial drug summaries, with drugs listed for ease of identification in alphabetical order by generic name. Each drug summary provides pharmacokinetic and pharmacodynamic data as well as toxicities and safety in pregnancy, in a very easy to find and read format. It was particularly gratifying that each antibiotic summary is extensively referenced—unusual to find in a concise text as this.
In summary, I recommend this book for the busy practicing generalist, infectious diseases specialist, or intensivist seeking a concise, easy to carry around reference for a quick guide to pneumonia. Whether on a busy in-patient service, or a full out-patient clinic, when confronted with suspected pneumonia, clinicians, especially house staff, will undoubtedly also appreciate the practical layout and to-the-point discussion.
Footnotes
-
The author has disclosed no conflicts of interest.
- Copyright © 2011 by Daedalus Enterprises Inc.