Sexually Transmitted Diseases. A Clinical Syndrome Approach

While there are many contemporary texts which deal with sexually transmitted diseases (STDs), the subtitle of this multi-authored volume-A Clinical Syndrome Approach-sets it apart from most other texts in that it is organized by chapters covering clinical syndromes rather than specific diseases or single pathogens. The editors state that this book ". . . is directed toward physicians, medical students, nurses, public health officials, and other paraprofessionals involved in the evaluation management and treatment of patients with STDs." To evaluate this book properly, I think it is important to note that they do not state that the book is aimed at academics, researchers, infectious disease specialists, or microbiologists working on organisms involved in STDs. The strength of this work is that it is intended for students and clinician-practitioners in a strictly practical approach. It delivers diverse information useful to those taking care of patients with STDs, no less, and little more. This is in contrast to the much larger text Sexually Transmitted Diseases, edited by King K. Holmes et al., which is over 1,000 pages long, with double columns, primarily organized by organisms, and which covers microbiology, immunology, pathogenesis, and also, extensively, the psychosocial aspects of STDs in much more detail. Of the 17 chapters in Spagna and Prior's volume, the majority are oriented toward a specific syndrome. These include chapters on "Vaginal Syndromes," "Genital Ulcer Syndromes," "Urethritis Syndromes," "The Gay Bowel Syndrome," "Acquired Immune Deficiency Syndrome," and others. These are practical chapters which include differential diagnoses, algorithms, and reference lists which offer citations mostly from the 1980s up to 1984, as well as a limited number of good-quality color pictures and anatomic drawings. Although the chapters are not, in general, related to single organisms, the editors have assigned some authors chapters on specific groups of organisms which are best dealt with outside the framework of specific syndromes. Among these are "Condyloma Acuminatum and Other Human PapillomavirusInduced Diseases," "Ectoparasites and Molluscum Contagiosum," and others. Finally, and perhaps best of all, there are four general chapters on practical general topics, "Basic Anatomy and Physiology," "Epidemiology of Sexually Transmitted Diseases," "Outpatient Approach to Sexually Transmitted Diseases," and "The Patient's Perspective." This last chapter by two nurses and a clinical associate of a venereal diseases clinic is in the form of reasonable answers to frequently asked questions: "What is venereal disease?" "Could I have gotten NGU from physical or emotional strain?," "Can I have sex when I have herpes?" and many, many more. I can recommend this volume to any person involved in an STD clinic from the receptionist to the director. I think that any ob/gyn trainee or practitioner would find that this book provides an excellent source for differential diagnosis, and medical students tired of the pathogen-by-pathogen approach to infectious diseases might find