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SPECIFIC OBJECTIVES – DAY 1 - NEW AND CHANGING DISEASES – Etiology and pathogenesis of these infections. Clinical approach and methods of diagnosing these infections. Management of these infections. HERPESVIRUS INFECTIONS – Clinically pertinent aspects of herpesvirus infections. Syndromes, clinical complications and attributes of recurrent disease. Management and use of anti-virals. VIRUSES TO BE COVERED INCLUDE – Herpes simplex virus; Epstein-Barr virus; Cytomegalovirus; Varicella-zoster virus; HHV6. URINARY TRACT INFECTION – Epidemiology of UTIs. Attributes of lower tract and upper tract infections and reinfections and relapses. Chronic bacterial prostatitis. Approach to antimicrobial therapy, to include the use of short course therapy. Approach to prevention. PROPHYLAXIS OF ENDOCARDITIS AND PROSTHETIC JOINTS: ISSUES FOR PRIMARY CARE – Current recommendations for antibiotic prophylaxis of endocarditis and prosthetic joints. Data supporting prophylaxis. Appropriate patients for prophylaxis. Administration of prophylactic antibiotics. Prophylaxis in the allergic patient. SEXUALLY TRANSMITTED DISEASES – Current understanding of the epidemiology of common STDs. Attributes of clinical presentations. Diagnostic approaches. Current treatment recommendations. DAY 2 - HEPATITIS – Pathogenesis and clinical manifestations of hepatitis A, B, C, D or E. Differences in rates of complications. Treatment options for hepatitis B, C and their rates of success. TRAVEL HEALTH – General preventive measures including what not to eat and drink. Immunizations. Prevention of malaria, diarrhea and other illnesses of travelers. Management of diarrhea of travelers. HELICOBACTER PYLORI INFECTION – Clinical manifestations . Methods of diagnosing. Treatment. INFECTIVE DIARRHEA – Presentation of toxigenic and invasive diarrhea. Food-borne pathogens. When to use fecal WBC, stool cultures, and stool O&P examinations. Indications for antibiotic therapy. Appropriate antibiotic choices. ILLUSTRATIVE CASES – Expected clinical manifestations of the disorders presented. Appropriate therapeutic regimen for each case. Contraindications or possible resistance problems, if any, with each case. Expected outcomes of therapy for each case study. DAY 3 - NEWER ANTIBIOTICS – The antibacterial spectrum of activity. Pharmacology of the agents. Indications and dosing recommendations. Side effects, adverse reactions and drug interactions. ADULT IMMUNIZATIONS – Current recommendations for the following vaccine preventable diseases: influenza, pneumococcal infection, hepatitis B, hepatitis A, varicella-zoster, and meningococcal infection. UPDATE ON ANTIMICROBIAL RESISTANCE – Pattern of emergence of resistance to certain infecting bacteria. Epidemiology that may indicate potential resistance among the organisms discussed such as: Staphylococci; Pneumococci; Enterococci; Gram negative bacilli. Approach to current therapeutic regimens while considering resistance. HIV PRIMER FOR THE PRIMARY CARE PHYSICIAN – Latest epidemiology of HIV infection. Utility of diagnostic tests (e.g. viral load, CD4 count) and their application for disease management. Principles of antiretroviral treatment and currently available medications. Prophylaxis to prevent opportunistic infections. ILLUSTRATIVE CASE STUDIES – Expected clinical manifestations of the disorders presented. The appropriate therapeutic regimen for each case. Contraindications or possible resistance problems, if any, with each case. Expected outcomes of therapy for each case study. DAY 4 - COMMUNITY ACQUIRED PNEUMONIA – Microbial causes of community acquired pneumonia. Accepted methods, and potential pitfalls of making the diagnosis. Prognostic factors related to outcome. Treatment options according to severity of illness. SOFT TISSUE INFECTIONS: CELLULITIS, FASCIITIS AND THE DIABETIC FOOT – Typical and atypical manifestations. Pathogenesis. Principles of medical and surgical treatment. Prognosis. TUBERCULOSIS – Groups at risk for developing active tuberculosis. Principals of antituberculous therapy. Mantoux technique for tuberculin skin testing. Indications for treatment of latent TB infection. WHAT THE PRIMARY CARE PHYSICIAN SHOULD KNOW ABOUT ACUTE MENINGITIS – Epidemiology of meningitis and the different types of meningitis. Clinical signs and symptoms of different types of meningitis. Indications for lumbar puncture (LP) and interpretations of LP results. Treatment options and the need for hospitalization and public health notification. ILLUSTRATIVE CASES – Expected clinical manifestations of the disorders presented. Appropriate therapeutic regimen for each case. Contraindications or possible resistance problems, if any, with each case. Expected outcomes of therapy for each case study.
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