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Diagnostic Virology in Primary Care
Case vignettes for general practitioners and trainees in medical microbiology
Written by Dr Brendan Crowley MD FRCPath
Edited by Professor Anna Maria Geretti
MD PhD FRCPath
Price € 15.00
About the Book:
‘General practitioners are in the front line where viral diseases are concerned, and they may sometimes need support in what is a rapidly developing field. The twenty-first century has seen a revolution in the speed and range of laboratory diagnosis as well as a new phase in viral immunisation and antiviral treatment. Advances in clinical medicine have led to new susceptibilities to viruses, and pandemic viral diseases as well as expanding travel to the developing world, have led to viral exposures that were rarely encountered in the past.
This useful book is based on case vignettes that describe situations often seen in general practice. It is based on plentiful references to the current literature and brings the latest knowledge on laboratory diagnostics, infection control/public health measures and antiviral treatments to the attention of general practitioners and trainees in medical microbiology and public health medicine. It can also serve as a primer for postgraduate examinations in medicine. It can be read with interest and referred to with benefit.’
Prepublication review by Dr Philip Mortimer MD (London)
Written by Dr Brendan Crowley MSc MD DTM FRCPath FFPath(RCPI)
Edited by Professor Anna Maria Geretti MD PhD FRCPath
All royalties to LauraLynn Ireland’s Children Hospice
Registered Charity Number 20154844
One day, during my first month as a trainee in clinical virology, the senior medical registrar called in to the Virology department in a state of great distress. He had been feeling tired over the last couple of weeks and then that morning he had seen a faint rash on his torso. Could we take a look? Had he caught a nasty virus? Was this measles? A quick consultation and a blood sample followed, and two hours later a diagnosis of infection with parvovirus B19 was delivered to the registrar, alongside a full debrief about the virus and guidance on potentially vulnerable contacts. Since those early days and over the many years of clinical practice that followed, certain characteristics of this area of specialism have proved true for me again and again. It’s not just any old virus! Making a prompt, specific diagnosis of a viral aetiology is not only scientifically satisfactory, but also extremely helpful in guiding counselling, use or avoidance of medications and interventions, and appropriate referrals. Sometimes a prompt, specific diagnosis simply provides reassurance for the patient and their treating clinician. In many cases, it ensures vulnerable contacts can be adequately protected. Frequently, it provides surveillance data that merge with country-wide statistics to inform and preserve public health. The field evolves at a fast pace. The medical applications of virology are in constant motion, ready to take advantage of, and in many cases driving both technological advances that improve diagnostics and new understandings that advance drug development. However, the field is often seen as off-limits to non-specialists. That early experience as a trainee taught me that clinical virology is typically perceived as complex to master, and the challenges can appear both interesting and difficult. The range of diagnostic tests and their use and interpretation is often bewildering for the non-specialist, and there never seems to be enough time to dive into the large textbooks or make sense of multiple but often disparate online resources. If this sounds familiar, this book will prove a perfect companion to a busy day of practice.
When Dr Brendan Crowley asked me whether I would like to read the draft chapters of his book and provide feedback on the work in progress, I could immediately see the need and benefit. A highly valued colleague of many years, Brendan and I share a common passion for clinical virology and a strong desire to make the subject less intimidating for the non-specialist and trainees in medical microbiology and public health medicine. This is a book with a mission: not just to summarise the main features of viral infections, but to attempt to translate a vast field of knowledge and experience in succinct, practical guidance. The book is organised in chapters that cover specific viruses and broader syndromes, keeping firmly in mind the scenarios that are most likely to occur in general practice. The content spans common presentations such as gastroenteritis, skin rashes, influenza and infectious mononucleosis, while also giving consideration to specific populations, including pregnant women and travellers. The structure of the book allows the reader to dip in each chapter individually according to need. Clinical vignettes are drawn from everyday practice and prove effective in framing the discussion around the essential points. Each chapter briefly describes key scientific and clinical data as a background to the more practical aspects: the most common differential diagnoses, which test to use and how to interpret the results, and how to manage the patient in terms of treatment, infection control, and if indicated, application of public health measures to family and other contacts.
I am grateful for Brendan’s efforts towards explaining the topic of virology and its practice in primary care. I enjoyed reading each chapter of the book, and I feel sure that trainees in medical microbiology and colleagues in general practice, for whom the book was primarily conceived, will find it an essential guide to clinical virology, and a valuable tool for good clinical decision-making.
Anna Maria Geretti
MD PhD FRCPath
Professor of Virology and Infectious Diseases