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Infective disease


Infectious diseases (IDs) are among the most prevalent diseases in general medicine. When medical students start they journey in the hospital, first as students, later on as young medical doctors, they will frequently meet patients with community acquired infectious diseases like pneumonia, urinary tract infections, and soft tissue infections. They will rapidly understand the importance of preserving the live saving antibiotics for severe diseases avoiding overuse or misuse. In fact, the inappropriate use of antibiotics as undoubtedly contributed to the pandemic of multi-resistant bacteria, one of the major threats for future generations. Once emerging and deadly diseases like HIV and hepatitis C can now be considered as treatable diseases thank to the enormous progresses of basic and clinical research that lead to the development of potent antiviral drugs. However, newly emerging zoonotic infections like the SARS-Coronavirus-2 are still capable to cause epidemics and pandemics. It wasn’t easy to make a choice among the numerous fascinating topics of ID medicine!

First semester: During the introductory weeks we will discuss the differential diagnosis of a febrile patient (not every fever is an infection!). The primary aim is to provide the students with the basic knowledge in medical history taking and clinical examination to identify the important clues for a correct diagnosis. In the same course we will also address the most important prevention tools in ID, i.e. vaccines, applied to the fascinating field of travel medicine. In a second course, the students will learn how solve the mystery of “fever of unknown origin” and acquire the basic knowledge on infectious endocarditis, a less frequent ID, but of great importance because of its severity. A tight collaboration with the cardiologist and cardiac surgeon is of paramount importance for the successful management of endocarditis.

Finally, we will touch on a major topic in infectious diseases, i.e. HIV medicine, not forgetting the important interplay with other sexual transmitted diseases.

Second semester: Neutropenic fever is a life-treating condition and a common problem in oncologic patients. Broad spectrum antibiotics need to be prescribed immediately to avoid the rapid development of a septic shock. However, the diagnostic strategy to a correct diagnosis remains of fundamental importance to ensure that the initial empiric treatment can be changed in a specific treatment of the pathogen causing the disease. In the same course an hour will be dedicated to the prevention of vertical transmission of HIV in collaboration with a pediatrician specialized in ID.

Third semester: bone and joint infections can be acute or chronic and are caused by many different microorganisms, i.e. bacteria, mycobacteria, and fungi. It will be the occasion to know more in detail the most important pathogen in this context, i.e. Staphylococcus aureus. Bone and joint infections are particularly tricky when they also involve foreign bodies: A tight collaboration between ID physicians and orthopedic surgeons is needed to avoid catastrophic outcomes.

Fourth semester: Bacterial meningitis represents one of the most important emergencies in ID medicine. This important differential diagnosis must be considered for every patient presenting with headache and fever to allow rapid recognition of the disease and immediate treatment. Encephalitis, although quite rare, is an important differential diagnosis in case of altered consciousness and fever with or without focal  neurologic signs. The students will learn how a common and usually harmless virus, Herpes simplex, can cause a severe encephalitis with a bad outcome in case of a delayed antiviral treatment.

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