Infectious Diseases in Critical Care Medicine

Since the last edition, some infectious diseases, such asClostridium difficilediarrhea/
colitis, SARS (severe acute respiratory syndrome), HPS (hantavirus pulmonary syndrome),
avian influenza (H5N1), and swine influenza (H1N1) have become important in critical care
medicine.
Another important topic has been added on infections related to immunomodulating/
immunosuppressive agents. The widespread introduction of immune modulation therapy has
resulted in a recrudescence of many infections due to intracellular pathogens, which are
important to recognize in patients receiving these agents. Because miliary tuberculosis is so
important and is not an infrequent complication of steroid/immunosuppressive therapy, a
chapter on this topic also has been included in the third edition.
As mentioned, antibiotic resistance in the critical care unit is a continuing problem with
short- and long-term clinical consequences. Currently, methicillin-resistant Staphylococcos
aureusand vancomycin-resistant enterococci are the most important gram-positive pathogens
in critical care, and a chapter has been added on antibiotic therapy of these pathogens. Among
the multidrug-resistant aerobic gram-negative bacilli, Klebsiella pneumoniae, Pseudomonas
aeruginosa, andAcinetobacter baumanniicontinue to be difficult therapeutic problems, and a
chapter has been included on this important topic.
The contributors to the third edition ofInfectious Diseases in Critical Care Medicineare
nationally or internationally acknowledged experts in their respective fields. The authors have
been selected for their clinical excellence and experience. They are teacher-clinicians also
known for their ability to effectively distill the key points related to their topics.
The third edition is not just a compendium of current guidelines. Guidelines are not
definitive and for this reason often change over time. Guideline followers may not agree with
this book’s clinical approach which is evidence based, but tempered by clinical experience.
Especially in critical care, the key determinant of optimal patient care is experienced based
clinical judgment which the clinician contributors have provided.
In summary, the this edition is both up-to-date and better than ever. Now in its third
edition,Infectious Diseases in Critical Care Medicine, written by clinicians for clinicians, remains
the only major text exclusively dealing with the major infectious disease syndromes
encountered in critical care medicine.

Burke A. Cunha

Preface to the Third Edition xiii