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An infectious disease (ID) specialist focuses on the prevention, diagnosis and management of nosocomial (in-hospital) and community acquired infections. These specialists are usually consulted by other physicians and specialists when they are looking after patients with unknown infections and difficult to treat or resistant infections, such as drug resistant pneumonia and tuberculosis.
The ID specialist will manage patients with infections such a HIV over the long-term as these patients need to be monitored for a long period of time. This will ensure that these patients will have someone to care for them when they are experiencing issues with their medications such as adverse events or side effects, or if their viral load is increasing despite being compliant with their medication. The ID specialist will then have to review their medication and change it to something else.
An ID specialist needs to complete the following training in order to specialise in infectious diseases:
- In order to become a qualified medical doctor, they will have to complete a 5-6 years undergraduate medical degree.
- Following this, they have to complete a 1-2 year internship training phase where they are exposed to the different surgical and medical disciplines.
- The doctor will then be allowed to specialise and they will then complete a 4 year residency programme in internal medicine to become a qualified physician.
- To become an ID specialist, the physician will then have to complete a 2 year fellowship training programme in infectious diseases.
Diagnostic measures used by Infectious Disease Specialists
The ID specialist will take a comprehensive history from the patient and important information will include a family history, information regarding acute and chronic medication use (especially previous antibiotics to determine whether microbial resistance is a possibility), history of any previous infections and a travel and occupational history to determine whether the patient could have been infected with any tropical diseases.
The ID specialist will then examine the patient to look for any suspect lesions on the body or rashes that could indicate specific bacterial infections such as cellulitis with secondary septicaemia or meningitis.
The following are specialised investigations that the ID specialist will request in order to diagnose a patient's condition.
- Serological tests such as a full blood count (FBC), C-reactive protein (CPR), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) are used as markers to monitor infection. Other tests such as liver and kidney function blood tests are done to check whether these organs are being affected by the infection.
- Lumbar puncture to analyze the cerebrospinal fluid.
- Blood cultures.
- Gram staining.
- Polymerase chain reaction (PCR).
Treatments being used by Infectious Disease Specialists
ID specialists will prescribe numerous different antimicrobial agents to help treat infections, and this will depend on the infection being treated and the patient's health status.
The medications that are used are antiviral agents to treat viral infections, antibiotics to treat bacterial infections and antifungal agents treat fungal infections. These medications are prescribed to be used either orally or intravenously, with the latter being used to manage more severe infections.