Core Adult Internal Medicine Disciplines

Infectious Diseases

Topics

• Principles and management of infection: clinical assessment of the febrile patient; the use of simple microbiological investigations; initiation of appropriate empiric and directed antimicrobial therapy.
  
• Principles of evaluation of a patient with persistent fever despite antimicrobial therapy.
  
• Principles of immunization.
  
• Principles of antibiotic prophylaxis.
  
• The mechanisms of disease and host responses in infection.
  
• Infection in special hosts: infections in intensive care; surgical, orthopaedic, obstetric/gynaecological infection; infections associated with common reasons for immunocompromise, such as diabetes, alcohol abuse, chronic liver disease, old age, steroid treatment; neutropenic individuals; solid organ transplant recipients.
  
• Recognition and immediate management of acute infectious emergencies, including septicemia (including septic shock and sepsis syndrome), meningitis, falciparum malaria.
  
• Recognition and management of common community-acquired infection such as lower respiratory tract infection, urinary tract infection, skin and soft tissue infection, infective arthritis, enteritis, hepatitis, biliary tract infection, endocarditis and tuberculosis.
  
• Knowledge of clinical illness produced by bacterial, protozoal, helminthic, viral and fungal pathogens.
  
• Commonly used antimicrobial agents: basic knowledge of antimicrobial spectrum; doses and routes of administration and monitoring of drug levels; penetration into special sites (e.g. CSF, bone); use in the presence of organ dysfunction; major adverse effects.
  
• Principles of hospital-acquired infection: basic knowledge of risk factors in the hospitalized patient; common hospital-associated microorganisms.
  
• Principles of infection control in the community, including epidemiology; transmission and prevention of common infections which threaten a community (e.g. diarrhoeal illness, tuberculosis, meningococcal meningitis).
  
• Simple principles of infection control in hospital and notification of infectious diseases.
  
• Knowledge of infections from a variety of settings (e.g. nosocomial, sexual transmission, altered immune states, occupational and geographical settings).
  
• Evaluation of acutely ill, febrile travellers and patients from overseas.
  
• An approach to investigation of pyrexia of unknown origin.
  
• Diagnosis, evaluation and management of acute illness in HIV-infected individuals: recognition, counselling and testing; antiretroviral therapy; management of major complications and prophylaxis.
  
• Basic interpretation of laboratory results, (e.g. culture results, antibiotic susceptibilities and antibiotic levels).
  
• Issues related to genitourinary medicine:
  
  • Management of common sexually transmitted diseases (STDs); the spread and control of STDs: risk behaviour groups; sexual health education.
    
  • Aetiology and investigations for the management of: urethral discharge, vaginal discharge, cystitis, genital ulcer, proctitis, epididymitis, prostatitis, and reactive arthritis.
    
  • Knowledge of the common conditions: chlamydial and nonspecific genital infection, gonorrhoea, bacterial vaginosis, candidiasis, trichomoniasis, syphilis (including interpretation of serological tests), first and recurrent episodes of anogenital herpes simplex infection, anogential warts, Hepatitis B, scabies and pediculosis.
    
  • Sexual health/health promotion, including safe sex and condom use.

Practical Skills for all Trainees

• Blood cultures from peripheral and central sites.
  
• Tuberculin test.
  
• Wound culture.
  
• Aspiration of usually sterile sites (e.g. joint fluid, pleural fluid, CSF).
  
• Communication skills: taking an infectious diseases (including sexual) history;
  counselling for HIV antibody testing.

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