Adult infectious diseases: management in a general hospital

Conflicting views exist as to where patients with infectious diseases (IDs) are best managed. In an effort to define the role of an IDs Unit in this country, we undertook a four-year survey of IDs cases referred to our isolation facility which is part of the Gastroenterology department. Ninety-three per cent of 250 cases referred had either diarrhoea (48%) or jaundice (45%). Two thirds of the total had an infective, and one third a non-infective basis for their illness. Since diarrhoea and jaundice dominated the clinical presentations of these cases, having the IDs facility within the Gastroenterology department made for speedy diagnosis and management of both infectious and non-infectious cases. Where referral and/or transfer to other units was necessary, it still proved helpful to locate the IDs facility within a regional multidisciplinary hospital, particularly in view of the wide range of medical and surgical conditions referred as putative IDs.