Journal of Antimicrobial Chemotherapy (1999) 43, 850
© 1999 The British Society for Antimicrobial Chemotherapy
Book review |
Cases in Medical Microbiology and Infectious Diseases (book), 2nd edition
P.H. Gilligan, M.L. Smiley and D.S. Shapiro
MICRO II Cases in Medical Microbiology (CD-ROM)
R. Twarog, P.H. Gilligan, M.L. Smiley and D.S. ShapiroBlackwell Science, Oxford, 1997. ISBN 1-55581-106-X. £62.50.
Department of Microbiology, Royal Hallamshire Hospital, Sheffield, UK
Cases in Medical Microbiology comprises a soft-backed textbook and accompanying CD-ROM and attempts to `challenge students to develop a working knowledge of the variety of microorganisms that cause infection in humans' through a problem-based approach. The book contains details on 70 cases (said to be from actual patients) and asks questions in four areas: the organisms' characteristics and laboratory diagnosis, pathogenesis and clinical characteristics, epidemiology, and prevention; drug treatment is, quite correctly, only addressed when there is a clear consensus on therapy. Forty cases are new to the 2nd edition and many of the remainder are revised; cases are arranged in the six major organ systems and in new and re-emerging infectious diseases. Each section has a useful introductory overview and tables of commonly encountered organisms. There is a table of normal laboratory values and a glossary broadens the audience of the text beyond the medically qualified. The text is lavishly illustrated with 101 colour plates in 336 pages and addresses the whole gamut of infectious agents including bacteria, fungi, parasites, viruses and prions. This is an enjoyable approach to self-learning, encouraging the student to develop a differential diagnosis and is a useful adjunct to any medical course with a dwindling hands-on approach to microbiology.
The CD-ROM is a multimedia version of 34 selected cases that can be run (entirely from the CD-ROM) on most PC-compatible computers with any Windows platform and 8 megabytes of RAM: installation on a hard-drive or server requires 50 megabytes of free disk space. As in the hard copy version, one is provided with a scenario, patient history and significant findings (often the most appropriate details in reaching a diagnosis). One may then `visit' chemistry, haematology or microbiology laboratories or the radiology department to request any tests one deems necessary to make a diagnosis. If an appropriate test is requested, results are given: in the case of the microbiology laboratory (which, I feel, will be used the most), these may be in the form of an image or images. Upon collation of results, a series of MCQs ensures that the correct diagnosis has been made.
Again, this approach encourages the development of a differential diagnosis and intelligent use of laboratory facilities as the price of each test is added to the bill! The temptation is to make a diagnosis as cheaply as possible; however, hundreds of dollars (this is an American product) saved in attempting to make a diagnosis must be weighed against the thousands of dollars at stake in any litigation case. Further, the introduction of a price per test does not make the product inflation proof. Interestingly, I did not find the CD-ROM as enjoyable as the book, which is excellent and amply meets its goal. However, there does not appear to be a user fee and the disk would be an inexpensive acquisition for a medical school network, for example.
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