Preface

Our understanding of infectious diseases has increased exponentially over the past few decades with invention of new diagnostic tests and identification of new pathogens and diseases. We also have the recognition of new syndromes caused by well-known pathogens and the resurgence of "old" diseases, once thought conquered. The complexity of children receiving medical care in both the outpatient and inpatient settings has also increased substantially. Conditions that once required initial (e.g., pyelonephritis) or prolonged (e.g., osteomyelitis) hospitalization are now managed primarily in the outpatient setting. The survival of infants born prematurely and those with chronic illnesses has improved through advances in medical technology and systems of care. Healthcare delivery has also evolved with far greater emphasis on both achieving better outcomes at lower cost and improving the experiences of our patients and their families. Consequently, the amount of knowledge required to manage even common childhood infections can sometimes feel mind boggling. This book was written in order to provide general and specialty child-health clinicians—generalists and specialists—a practical, reliable, and evidence-based resource to diagnose and treat commonly encountered pediatric infections in the inpatient and outpatient settings.

The revised edition begins by addressing practical aspects such as basics of the practice of infectious diseases, including information about clinical microbiology and virology laboratory tests, infection control in office and hospital settings, and important concepts in infectious diseases epidemiology. This latter chapter we hope will provide the reader with insight into interpretation of contemporary clinical research. New to this edition are chapters on quality improvement and chapters on anti-infective agents, emphasizing the growing importance of rigorous assessment of our interventions and the need to maximize knowledge of the growing number of agents available for treatment of childhood infections. Additionally, as an increasingly vocal anti-vaccine movement threatens to undermine hard-won public health gains, the revised chapter on vaccines places greater emphasis on communication about vaccine safety and risk. The next section covers common signs and symptoms for which infections are often part of the differential diagnosis. Subsequent sections review infections by anatomic site with emphasis on providing practical guidance for diagnosis and management. The book addresses many special situations that fall outside the scope of organ systems such as perinatally acquired infections and care of children with human immunodeficiency virus infection. We also cover topics such as infections in children with atopic dermatitis or neurologic impairment and infections in internationally adopted children that often fall outside the scope of traditional textbooks.

In organizing this book, we strove to ensure that chapters were sufficiently detailed and thoroughly referenced while also adhering to our philosophy of providing practical management strategies. Our expert authors, to whom we are extremely grateful, succeeded in reaching this objective in a timely manner. We hope this book will serve as a daily infectious diseases consultant to the practicing pediatrician.