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Infections in Outpatient Practice
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The intent of this book is to provide a practical approach to the recognition and therapy of selected outpatient problems faced by the internist, family practi- tioner, house officer, physician's assistant, and nurse. The topics selected were based on problems often encountered by clinicians in the outpatient setting, as well as by the interests of the authors. No attempt was made to write an all- encompassing textbook of infectious disease. We want to thank Dr. John Czachor, infectious disease fellow, Saint Vin- cent Hospital, for his contributions to two chapters: mononucleosis and mono- nucleosislike syndromes and selective laboratory studies. We want to thank Suzanne Hedstrom and Sharon Budzyna for typing and preparing the manuscript. Finally, we would like to give special recognition to our wives, Brenda, Roberta, and Bonnie, for their support during the preparation of this book. Richard A. Gleckman Nelson M. Gantz Richard B. Brown Worcester and Springfield v Contents 1 Immunization in Adults Richard B. Brown Definitions and Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Immunization in Special Clinical Situations . . . . . . . . . . . . . . . . 5 Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 College Students and Military Recruits . . . . . . . . . . . . . . . . . 6 Health Care Personnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Travelers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Vaccines of Especial Use to Travelers . . . . . . . . . . . . . . . . . . . . 7 Typhoid Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Yellow Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Cholera. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Japanese B Encephalitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Immune Serum Globulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Strategies for Use of Other Commonly Employed Vaccines in Specific Clinical Situations . . . . . . . . . . . . . . . 9 Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Rabies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Pneumococcal Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Viral Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Hepatitis B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 vii viii CONTENTS 2 Infectious Disease Problems for the Traveler Richard B.
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Table of Contents

1 Immunization in Adults.- 2 Infectious Disease Problems for the Traveler.- 3 Intestinal and Lymphatic Infectious Disorders in the Male Homosexual.- 4 Outpatient Management of Acquired Immunodeficiency Syndrome.- 5 Sinusitis and Pharyngitis.- 6 Infectious Bronchitis.- 7 Management of Pneumonia in Outpatients.- 8 Urethral Discharge.- 9 Vaginal Discharge.- 10 Outpatient Urinary Tract Infections in Young Women.- 11 Mononucleosis and Mononucleosislike Syndromes.- 12 Chronic Fatigue Syndrome.- 13 Management of Infectious Diarrhea.- 14 Cutaneous Infections in the Office Setting.- 15 Management of Bites from Dogs, Cats, and Humans.- 16 Endocarditis Prophylaxis.- 17 Tuberculin Skin Testing and Managing a Positive Tuberculin Reactor.- 18 Selective Laboratory Studies.- 19 Home Intravenous Antibiotic Therapy.

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