Differential diagnosis in internal medicine : from symptom to diagnosis PDF
Preview Differential diagnosis in internal medicine : from symptom to diagnosis
Edited by Foxit PDF Editor Copyright (c) by Foxit Software Company, 2004 For Evaluation Only. I Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. II Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Differential Diagnosis in Internal Medicine From Symptom to Diagnosis Walter Siegenthaler, MD Professor Emeritus of Internal Medicine University of Zürich Zürich, Switzerland With contributions by A. Aeschlimann, E. Baechli, C. Bassetti, E. Battegay, M. Battegay, K. Bloch, H.E. Blum, F. Duru, F.R. Eberli, T. Fehr, A. Fontana, M. Fox, M. Fried, K. Hess, U. Hoffmann, D. Jaeger, M. Kraenzlin, H. Kupferschmidt, S. Lautenschlager, B. Michel, E. Oechslin, P. Ott, P. Peghini, E.W. Russi, N. Schaefer, C. Scharf, C. Schmid, U. Schwarz, G.A. Spinas, S. Stoeckli, F. Tató, A. von Eckardstein, R. Weber, R.P. Wuethrich Specialist Consultants A.Aeschlimann:Rheumatology A.Knuth:Hematology,Oncology M.Battegay:FundamentalsofDifferentialDiagnosis E.W.Russi:Pneumology H.E.Blum:Gastroenterology,Hepatology G.A.Spinas:Endocrinology,Diabetology F.R.Eberli:Cardiology R.Weber:Infectiology P.Greminger:GeneralInternalMedicine R.P.Wuethrich:Nephrology K.Hess:Neurology 789 illustrations 323 tables Thieme Stuttgart · New York III Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. LibraryofCongressCataloging-in-PublicationData Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical SiegenthalersDifferentialdiagnose.English. experience are continually expanding our knowledge, in Differential diagnosis in internal medicine / [edited by] particular our knowledge of proper treatment and drug WalterSiegenthaler;withcontributionsbyA.Aeschlimann therapy.Insofarasthisbookmentionsanydosageorappli- ...[etal.];specialistconsultants,A.Aeschlimann...[etal.].-- cation,readersmayrestassuredthattheauthors,editors, 1stEnglished. andpublishershavemadeeveryefforttoensurethatsuch p.;cm. referencesareinaccordancewiththestateofknowledge ISBN978-3-13-142141-8(TPS:alk.paper)-- atthetimeofproductionofthebook. ISBN 978-1-58890-551-2 (TPN : alk. paper) 1. Diagnosis, Nevertheless, this does not involve, imply, or express Differential.2.Physicaldiagnosis.3.Internalmedicine.I. anyguaranteeorresponsibilityonthepartofthepublishers Siegenthaler,Walter,1923-II.Title. inrespecttoanydosageinstructionsandformsofapplica- [DNLM: 1. Diagnosis, Differential. 2. Internal Medicine. tions stated in the book. Every user is requested to ex- WB141.5S5712007a] aminecarefullythemanufacturers’leafletsaccompanying RC71.D54472007 eachdrugandtocheck,ifnecessaryinconsultationwitha 616.07'5--dc22 physicianorspecialist,whetherthedosageschedulesmen- 2007004243 tionedthereinorthecontraindicationsstatedbythemanu- facturers differ from the statements made in the present book. Such examination is particularly important with ThisfirstEnglisheditionisarevisedandupdated drugs that are either rarely used or have been newly re- authorizedtranslationofthe19thGermaneditionpub- leasedonthemarket.Everydosagescheduleoreveryform lishedandcopyrighted2005byGeorgThiemeVerlag, ofapplicationusedisentirelyattheuser’sownriskandre- Stuttgart,Germany.TitleoftheGermanedition:Siegen- sponsibility.Theauthorsandpublishersrequesteveryuser thalersDifferentialdiagnose:InnereKrankheiten−vom toreporttothepublishersanydiscrepanciesorinaccura- SymptomzurDiagnose. ciesnoticed.Iferrorsinthisworkarefoundafterpublica- tion,erratawillbepostedatwww.thieme.comonthepro- ductdescriptionpage. ©2007GeorgThiemeVerlag, Someoftheproductnames,patents,andregistereddesigns Rüdigerstrasse14,70469Stuttgart, referredtointhisbookareinfactregisteredtrademarksor Germany proprietary names even though specific reference to this http://www.thieme.de factisnotalwaysmadeinthetext.Therefore,theappear- anceofanamewithoutdesignationasproprietaryisnotto ThiemeNewYork,333SeventhAvenue, beconstruedasarepresentationbythepublisherthatitis NewYork,NY10001,USA inthepublicdomain. http://www.thieme.com Thisbook,includingallpartsthereof,islegallyprotected Illustrator:JoachimHormann,Stuttgart,Germany; by copyright. Any use, exploitation, or commercialization Plankensteiner+Hanig,Esslingen,Germany; outside the narrow limits set by copyright legislation, AndreaSchnitzler,Innsbruck,Austria withoutthepublisher’sconsent,isillegalandliabletopros- ecution. This applies in particular to photostat reproduc- Coverdesign:ThiemePublishingGroup tion, copying, mimeographing, preparation of microfilms, TypesettingbyprimustypeHurler,Notzingen,Germany andelectronicdataprocessingandstorage. PrintedinGermanybyAPPL,aprintadruck,Wemding, Germany ISBN978-3-13-142141-8(TPS,RestofWorld) ISBN978-1-58890-551-2(TPN,TheAmericas) 123456 IV Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Preface Preface Thepresentbook,DifferentialDiagnosisinInternal dermatology, neurology, and rheumatology. The Medicine, first appeared as a German edition in book incorporates many relevant and instructive 1952 and since then has been translated into 10 illustrations, tables, graphics, and algorithms, all other languages. Over the past 50 years 19 Ger- contributing to the process of narrowing down a man editions have been published, and now the definitive diagnosis. 19th edition of the work, which has become the Thebookisintendedformedicalstudents,phy- classicdifferentialdiagnosistextbook,isavailable siciansinclinicalpractice,generalists,andspecial- inEnglishforthefirsttime. istsininternalmedicine,dermatology,neurology, This book encompasses differential diagnosis andrheumatology,andalsoforallthoseconcerned across the spectrum of internal medicine, cover- with the fundamental subjects of medicine, who ing dermatology, neurology, and rheumatology, wish to gain a competent knowledge of internal andprovidestheverylatestknowledgeincluding medicine. pathophysiological aspects. In contrast to ency- Mythanksareduetoallofthecolleagueswho clopedicallystructuredtextbooks,thisbooktraces workedwithmeonthebook,andalsotoThieme the path from symptom to diagnosis, just as the PublishingGroup,inparticularThiemePublishers physicianencountersthesituationinthehospital Stuttgart.Ihopethat,withthelaunchoftheEng- and in the office. lishedition,thisclassictextbookofdifferentialdi- With this pragmatic approach—starting from agnosisininternalmedicinewillnowalsofindits the symptom(s)—the physician will usually suc- place in the English-speaking world. ceed in substantiating the suspected diagnosis. Using this method, Siegenthaler’s Differential Di- Walter Siegenthaler, MD agnosis in Internal Medicine guides the reader Professor Emeritus of Internal Medicine through the differential diagnostic challenges in University of Zürich the entire field of internal medicine, including Zürich, Switzerland V Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Contributors VI Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Foreword Foreword I first met Professor Walter Siegenthaler in the ourdailyinteractionswithpatientsmayseemun- 1970s while he was at the University of Zürich, clear or too complex. Siegenthaler’s Differential wherebothheandhislatewife,thesuperbclini- Diagnosis in Internal Medicine reminds us to ap- cianDoctorGertrudSiegenthaler-Zuber,weread- proachdiagnosticproblemsinapractical,system- miredfortheirmanyaccomplishmentsanddedi- atic, and critical manner, remembering that each cation to the advancement of medicine. At that patient’s circumstance is unique and that it is time,ProfessorSiegenthalerhelpedmeestablisha everydoctor’sresponsibilitytoexercisehisorher program to bring cardiologists from the Baylor best educated judgment to present rational CollegeofMedicineandtheMethodistHospitalin choices about the most probable diagnoses and Houston, Texas, to Switzerland to study the optimaltreatmentcourses.Occam’sRazor,which pioneering balloon angioplasty work of Andreas advisesusthatthesimplestexplanationisusually Gruentzig. Subsequently, he honored us by serv- the correct one, all things being equal, is an im- ingasaVisitingProfessoratBaylor,exemplifying portant precept in diagnostic medicine, yet doc- the best of Swiss medicine. Now, 30 years later, torsmustalsobeflexibleandadaptabletotheec- Professor Siegenthaler remains at the leading centricitiesofeverycase.Thus,physiciansshould edgeofmedicine,asthisexpertlyrealizedbookin notexpecttoseeazebrawhenconfrontedwitha your hands attests. horse, but they should be able to recognize the Differentialdiagnosisisthefundamentalmeth- zebra on the rare occasion that it makes an ap- odologyofmodernclinicalmedicine:wenotethe pearance. patient’s symptoms; we develop hypotheses for Ibelievethatthescholarship,clinicalskill,and the affliction and propose treatment; and we ad- practical wisdom that Professor Siegenthaler and just treatment based on the patient’s response. hiscolleaguessharewithusinthistextareindis- Thus,differentialdiagnosisrequiresthephysician pensable resources for the medical community. to be observant, knowledgeable, thoughtful, The wealth of illustrative photographs, informa- thorough,andorganized,qualitiesthatcouldalso tivetables,andup-to-datediscussionofissuesin beusedtodescribetheconceptualizationandex- internal medicine will prove very useful in daily ecutionofthefollowingpages.Inthelastfewde- clinical practice. cades, we have seen stunning advances in the level of clinical care and diagnostic procedures AntonioM.Gotto,Jr.,MD,DPhil available across the spectrum of human diseases. TheStephenandSuzanneWeissDean The sophistication of contemporary nosology is Professor of Medicine truly impressive. WeillCornellMedicalCollege Ontheotherhand,therapidturnoverofmedi- Provost for Medical Affairs calinformationcanprovedauntingtomanyclini- Cornell University cians,andtheapplicationofthelatestevidenceto New York, USA VII Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Contributors Contributors Editor Prof.Dr.med.Dr.h.c.WalterSiegenthaler Forsterstr.61 8044Zürich,Switzerland Authors AndréAeschlimann,MD HubertE.Blum,MD MarkFox,MD Professor ProfessorandDirector ResearchConsultant RehaClinicZurzach DepartmentofInternalMedicineII UniversityHospitalZürich Zurzach,Switzerland UniversityMedicalCenter Zürich,Switzerland Freiburg,Germany EstherBaechli,MD MichaelFried,MD SpitalUster ThomasBombeli,MD Professor MedicalClinic AssociateProfessor UniversityHospitalZürich Uster,Switzerland ResearchandDevelopment DepartmentofInternalMedicine NovoNordiskS/A DivisionofGastroenterology ClaudioBassetti,MD Bagsvaerd,Denmark andHepatology Professor Zürich,Switzerland UniversityHospitalZürich FiratDuru,MD ClinicandPoliclinicforNeurology Professor PeterGreminger,MD Zürich,Switzerland UniversityHospitalZürich Professor DepartmentofInternalMedicine StGallenCantonHospital EdouardBattegay,MD DivisionofCardiology DepartmentofInternalMedicine Professor CardiovascularCenter StGallen,Switzerland UniversityHospitalBasel Zürich,Switzerland MedicalPoliclinic KlausHess,MD Basel,Switzerland FranzEberli,MD Professor AssociateProfessor UniversityHospitalZürich ManuelBattegay,MD UniversityHospitalZürich ClinicandPoliclinicforNeurology Professor DepartmentofInternalMedicine Zürich,Switzerland UniversityHospitalBasel DivisionofCardiology DepartmentofMedicine CardiovascularCenter UlrichHoffmann,MD DivisionofInfectiology Zürich,Switzerland Professor Basel,Switzerland UniversityofMunichHospital JoergFehr,MD VascularCenter—Angiology PeterBauerfeind,MD Professor Munich,Germany AssociateProfessor UniversityHospitalZürich UniversityHospitalZürich DepartmentofInternalMedicine SabinaHunziker,MD DepartementofInternalMedicine DivisionofHematology UniversityHospitalBasel DivisionofGastroenterology Zürich,Switzerland MedicalPoliclinic andHepatology Basel,Switzerland Zürich,Switzerland ThomasFehr,MD AssociateProfessor DirkJaeger,MD KonradBloch,MD CenterforNephrology AssociateProfessor Professor UniversityHospitalZürich DirectorofClinicalOncology UniversityHospitalZürich Zürich,Switzerland NationalCenterforTumorDiseases DepartmentofInternalMedicine Heidelberg,Germany DivisionofPneumology AdrianoFontana,MD Zürich,Switzerland Professor AlexanderKnuth,MD UniversityHospitalZürich Professor FacultyofMedicine UniversityHospitalZürich DepartmentofInternalMedicine ClinicandPoliclinicforOncology DivisionofClinicalImmunology Zürich,Switzerland Zürich,Switzerland VIII Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Contributors MariusKraenzlin,MD PeterOtt,MD GiatgenA.Spinas,MD AssociateProfessor Professor Professor Basel,Switzerland UniversityHospitalZürich UniversityHospitalZürich OtorhinolaryngologyPoliclinic DepartmentofInternalMedicine HugoKupferschmidt,MD Zürich,Switzerland DivisionofEndocrinology SwissToxicologyInformation andDiabetology Center(STIZ) PietroPeghini,MD Zürich,Switzerland Zürich,Switzerland UniversityHospitalZürich DepartmentofInternalMedicine S.Stoeckli,MD StephanLautenschlager,MD DivisionofHematology AssociateProfessor AssociateProfessor Zürich,Switzerland UniversityHospitalZürich DermatologyClinic OtorhinolaryngologyClinic StadtspitalTriemli ErichW.Russi,MD Zürich,Switzerland Zürich,Switzerland Professor UniversityHospitalZürich FedericoTató,MD Hans-PeterMarti,MD DepartmentofInternalMedicine AssociateProfessor Professor DivisionofPneumology UniversityofMunichHospital UniversityHospitalZürich Zürich,Switzerland VascularCenter—Angiology DepartmentofInternalMedicine Munich,Germany DivisionofNephrology NiklausSchaefer,MD Zürich,Switzerland UniversityHospitalZürich MiriamThumshirn,MD ClinicandPoliclinicforOncology AssociateProfessor BenedictMartina,MD Zürich,Switzerland UniversityHospitalZürich AssociateProfessor DepartmentofInternalMedicine BaselUniversityHospital UrsSchanz,MD DivisionofGastroenterology MedicalPoliclinic AssociateProfessor andHepatology Basel,Switzerland UniversityHospitalZürich Zürich,Switzerland DepartmentofInternalMedicine DariusMoradpour,MD DivisionofHematology ArnoldvonEckardstein,MD Professor Zürich,Switzerland Professor VaudoisUniversityHospital UniversityHospitalZürich Gastroenterologyand ChristophScharf,MD InstituteofClinicalChemistry HepatologyService AssociateProfessor Zürich,Switzerland Lausanne,Switzerland KlinikimPark Zürich,Switzerland RainerWeber,MD BeatMuellhaupt,MD Professor AssociateProfessor ChristophSchmid,MD UniversityHospitalZürich UniversityHospitalZürich Professor DepartmentofInternalMedicine DepartmentofInternalMedicine UniversityHospitalZürich DivisionofInfectiousDiseases DivisionofGastroenterology DepartmentofInternalMedicine andHospitalHygiene andHepatology DivisionofEndocrinology Zürich,Switzerland Zürich,Switzerland andDiabetology Zürich,Switzerland RudolfP.Wuethrich,MD BeatA.Michel,MD Professor Professor UrsSchwarz,MD UniversityHospitalZürich UniversityHospitalZürich AssociateProfessor DepartmentofInternalMedicine RheumatismClinicand UniversityHospitalZürich DivisionofNephrology InstitituteofPhysicalMedicine ClinicandPoliclinicforNeurology Zürich,Switzerland Zürich,Switzerland Zürich,Switzerland ErwinOechslin,MD WernerSchwizer,MD Professor AssociateProfessor DirectorCongenitalCardiacCentre UniversityHospitalZürich forAdults DepartmentofInternalMedicine UniversityHealthNetwork DivisionofGastroenterology Toronto,Canada andHepatology Zürich,Switzerland IX Siegenthaler, Differential Diagnosis in Internal Medicine, © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license.
The list of books you might like
