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Diagnosis of Infectious Diseases

Diagnosis of Infectious Diseases - Diagnosis of Infectious...

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Diagnosis of Infectious Diseases Diagnosis: literally "knowledge of the day" Prognosis: literally "knowledge of tomorrow" The purpose of a diagnosis is simply to form a basis on which to make a decision about how to manage the disease in question. Thus, diagnosis is directly linked to the concept of treatment. This is in distinction of the process of mass screening for disease prevalence where the purpose is to gather data for epidemiological purposes. Of course, in such a screen, clinically ill individuals will (should) be treated. The contemporary view of diagnosis in traditional medical establishments with respect to infectious diseases is that an illness is ascribed to one (and only one) pathogen which is treated by one or very few procedures. This contrasts with holistic medicine [this is an OPTIONAL link] that says clinical illness is not due to a single etiological process or organism but rather to a combination of factors, some of which are intrinsic to the patient, and treatment should approach the problem from a number of perspectives. All diagnostic methods have to deal with two variables: 1. the occurence of false negatives 2. the occurence of false positives These possibilities result from the level of sensitivity and the level of specificity of the test. The relationships between these factors is clear: 1. if a test is very sensitive, it will detect very low numbers of the target 2. if a test is very specific, it will detect ONLY the desired target and none other 3. it is difficult to design a test that is BOTH specific AND sensitive for example, a very sensitive test is likely to detect not just the desired target but others as well and a very specific test will probably not detect low numbers of the target Methods 1. Clinical Although there are clearly some which, are readily diagnosed simply by a visual examination, most infectious diseases are diagnosed by a combination of clinical examination and laboratory tests. As part of the examination, the physician extracts a history from the patient. This is probably one of the most difficult aspects of making a diagnosis for many reasons we can't go into here. However, the most important aspect of history taking is the determination of recent travels of the patient. All too often this question is not asked and life-threatening tropical diseases can go completely undiagnosed. Again, the clinical examination is used as a basis for the physician to
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