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Sequelae and Long-Term Consequences of Infectious Diseases Print E-mail
Pina M. Fratamico, James L. Smith, and Kim A. Brogden, Eds. ASM Press, Washington, D.C., 2009, 534 p., $149.95 (hardcover).

The editors of Sequelae and Long-Term Consequences of Infectious Diseases, together with authors from North America and Europe, discuss in 28 chapters those chronic diseases which are known or suspected to be linked to the activities of infectious agents. Why do we focus on infectious diseases as causes of chronic illnesses? Carbone, the author of the first chapter, answered this question as follows: "Unlike many incurable chronic medical diseases, diseases caused by infectious etiologies may be prevented or cured through medical treatments (e.g., vaccines or antimicrobials, respectively) that are a fraction of the cost of lifetime chronic medical care. Thus, the desire to find an infectious cause of major chronic medical illnesses stems, in part, from the hope of curing or preventing these illnesses." There are, however, many difficulties in studying a causal link, including the life cycle of the infectious agent, the disease mechanism, and technical barriers to identifying agents. There are also psychological, sociological, and personal barriers to changing medical dogmata.

Many chronic illnesses have been associated with infectious agents. Bacterial causes are described in Chapters 2 through 11. In brief, Chapter 2 discusses late manifestations of Lyme borreliosis and Chapter 3 the association of Chlamydia with chronic illnesses of the respiratory tract, the eye, and the genital tract. In Chapter 4, the role of various enteric pathogens in chronic gastrointestinal diseases is evaluated. The fifth chapter is about the long-term consequences associated with Escherichia coli chronic infection. Chapter 6 focuses on streptococci and staphylococci in persistent infection, while Chapter 7 discusses Helicobacter pylori and its association with chronic gastric inflammation and extragastric illnesses. The role of mycobacteria in tuberculosis, paratuberculosis, and leprosy is examined in Chapter 8. The following chapter describes complications of Neisseria gonorrhoeae infection. Chapter 10 is about the association of Treponema with chronic (untreated) syphilis. Finally, Chapter 11 discusses the role of Tropheryma in Whipple's disease, a rare multisystemic chronic infection.

Chapter 12 and Chapters 14 through 16 focus on chronic illnesses caused by protozoa, while Chapters 13 and 17 investigate chronic disease manifestations caused by helminths. In some more detail, the longterm consequences of Toxoplasma gondii infection are examined in Chapter 12 and the role of Cryptosporidium infection in immunocomptent and immunodeficient individuals is covered in Chapter 14. Chronic malaria is the topic of Chapter 15, and chronic complications caused by Leishmania and Trypanosoma are covered in Chapter 16. The chapters on helminths include the description of the role of the cestode Taenia solium in chronic cysticercosis (Chapter 13) and of the role of nematodes, trematodes, and additional cestodes in postinfectious long-term clinical complications (Chapter 17).

Furthermore, there are four chapters in which authors discuss viral infections and their linkage to chronic diseases. For example, the eighteenth chapter is about acute viral infections with rare late complications, and the nineteenth chapter provides an overview about latent viral infections. There is also a review of chronic viral hepatitis (Chapter 20) and of socalled "slow viral infections" (Chapter 21).

The 22nd chapter describes complications of superficial mycoses, while the 23rd chapter deals with systemic and subcutaneous mycoses. Prion diseases are reviewed in Chapter 24. This is followed by a discussion about polymicrobial diseases (Chapter 25). The authors of this chapter focus primarily on periodontal disease (including the link to Porphyromonas infection) and the suggested association with long-term chronic systemic diseases, such as atherosclerosis, coronary as well as peripheral artery disease, cerebrovascular disease, and the exacerbation of preexisting chronic conditions.

The final three chapters also contain valuable information. Chapter 26 describes chronic diseases that are "in search of" an infectious agent (e.g., autism, rheumatoid arthritis, ulcerative colitis, chronic fatigue syndrome, and multiple sclerosis). Chapter 27 outlines various epidemiological methods that can be used to implicate specific infectious agents with long-term complications. The last chapter (Chapter 28) discusses future possibilities of studying chronic diseases with infectious causes. This book contains comprehensive scientific information. It is well illustrated (including a series of high-quality color plates) but, for clarity, the large number of chapters could have been divided into sections (e.g., bacterial causes, viral causes, etc.). Nevertheless, this book will be of great interest to many professionals (e.g., clinicians, research scientists, and advanced graduate-level students) who have an interest in chronic disease etiologies.

Christian T. K.-H. Stadtländer
St. Paul, Minn.
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