Menu
Your Cart

Harrison's Principles of Internal Medicine, 21E (Vol.1 & Vol.2)

Harrison's Principles of Internal Medicine, 21E  (Vol.1 & Vol.2)
-10 %
Harrison's Principles of Internal Medicine, 21E (Vol.1 & Vol.2)
  • ISBN: 9781264285846
  • Publisher: McGraw-Hill
  • Pages: 4384
  • Year Published: 2022
139.00€
155.00€
Ex Tax: 131.13€

The Voice of Clinical Reason

A Doody's Core Title for 2022! 
Harrison’s Principles of Internal Medicine is the world's most trusted clinical medicine text—and a superb resource for learning the art and science of clinical reasoning. Recognized by healthcare professionals worldwide as the leading authority on applied pathophysiology and clinical medicine, Harrison’s Principles of Internal Medicine provides the informational foundation you need for the best patient care possible. This new edition is fully updated with timely new chapters and essential updates across the spectrum of internal medicine. 

Written and edited by the world’s top experts in their respective fields, this landmark guide provides comprehensive, accurate, and essential coverage of the pathogenesis, diagnosis, and treatment of disease. 

Harrison’s is world-renowned as the most authoritative source for: 

• Clear, concise schemas that facilitate the generation of differential diagnoses to reason efficiently through complex real world clinical cases
• The physiologic and etiologic basis of signs and symptoms, which are covered through a wealth of unsurpassed expert guidance and linked to the disease-specific chapters that follow
• Updated clinical trial results and recommended guidelines
• Excellent and extensive visual support, including radiographs, clinical photos, schematics, and high-quality drawings
• Coverage of both therapeutic approaches and specific treatment regimens
• Practical clinical decision trees and algorithms
• Organ/system-specific sections, with clinically relevant pathophysiology and practical clinical advice on the approach to the patient, strategies towards building a differential diagnosis, outstanding clinical algorithms and diagnostic schema, a wealth of clinical images and diagrams, current clinical guidelines, and general and specific approaches to therapy

Harrison’s remains the most trusted resource in a world influenced by endless sources of medical information. The most timely and comprehensive updates from the world’s top experts are featured in the 21st edition: 

• Current coverage of the diagnosis and treatment of diseases, from COVID to dementia to sepsis to multiple sclerosis to lung cancer
• Updated content that reflects new approved therapeutics and new practice-changing guidelines and evidence summaries
• More than 1000 clinical, pathological, and radiographic photographs, diagnostic and therapeutic decision trees, and clear schematics and diagrams describing pathophysiologic processes
• Numerous atlases featuring curated collections of important visual aspects of diagnosis and management
• Updated and time-saving curation and synthesis of established and new medical literature and studies
• Clinically relevant coverage of disease mechanics and pathophysiology, and related therapeutic mechanisms


Contributors............................................................................. xviii
Preface ..................................................................................... xxxix
Harrison’s Related Resources.........................................................xl
PART 1 The Profession of Medicine
1 The Practice of Medicine....................................................1
The Editors
2 Promoting Good Health.....................................................8
Donald M. Lloyd-Jones, Kathleen M. McKibbin
3 Vaccine Opposition and Hesitancy....................................13
Julie A. Bettinger, Hana Mitchell
4 Decision-Making in Clinical Medicine.............................21
Daniel B. Mark, John B. Wong
5 Precision Medicine and Clinical Care................................30
The Editors
6 Screening and Prevention of Disease.................................37
Katrina A. Armstrong, Gary J. Martin
7 Global Diversity of Health System Financing
and Delivery.....................................................................42
Richard B. Saltman
8 The Safety and Quality of Health Care..............................50
David W. Bates
9 Diagnosis: Reducing Errors and Improving Quality..........54
Gordon Schiff
10 Racial and Ethnic Disparities in Health Care.....................59
Lenny López, Joseph R. Betancourt
11 Ethical Issues in Clinical Medicine....................................67
Christine Grady, Bernard Lo
12 Palliative and End-of-Life Care........................................72
Ezekiel J. Emanuel
PART 2 Cardinal Manifestations and
Presentation of Diseases
SECTION 1 Pain
13 Pain: Pathophysiology and Management...........................91
James P. Rathmell, Howard L. Fields
14 Chest Discomfort...........................................................100
David A. Morrow
15 Abdominal Pain..............................................................108
Danny O. Jacobs
16 Headache........................................................................112
Peter J. Goadsby
17 Back and Neck Pain........................................................117
John W. Engstrom
SECTION 2 Alterations in Body Temperature
18 Fever..............................................................................130
Neeraj K. Surana, Charles A. Dinarello, Reuven Porat
19 Fever and Rash...............................................................133
Elaine T. Kaye, Kenneth M. Kaye
20 Fever of Unknown Origin...............................................145
Chantal P. Bleeker-Rovers, Catharina M. Mulders-Manders,
Jos W. M. van der Meer
SECTION 3 Nervous System Dysfunction
21 Syncope..........................................................................152
Roy Freeman
22 Dizziness and Vertigo.....................................................159
Mark F. Walker, Robert B. Daroff
23 Fatigue...........................................................................162
Jeffrey M. Gelfand, Vanja C. Douglas
24 Neurologic Causes of Weakness and Paralysis..................165
Stephen L. Hauser
25 Numbness, Tingling, and Sensory Loss...........................168
Stephen L. Hauser
26 Gait Disorders, Imbalance, and Falls...............................173
Jessica M. Baker
27 Confusion and Delirium.................................................178
S. Andrew Josephson, Bruce L. Miller
28 Coma.............................................................................183
S. Andrew Josephson, Allan H. Ropper, Stephen L. Hauser
29 Dementia........................................................................189
William W. Seeley, Gil D. Rabinovici, Bruce L. Miller
30 Aphasia, Memory Loss, and Other Cognitive
Disorders........................................................................195
M.-Marsel Mesulam
31 Sleep Disorders...............................................................204
Thomas E. Scammell, Clifford B. Saper, Charles A. Czeisler
SECTION 4 Disorders of Eyes, Ears, Nose, and Throat
32 Disorders of the Eye........................................................215
Jonathan C. Horton
33 Disorders of Smell and Taste...........................................232
Richard L. Doty, Steven M. Bromley
34 Disorders of Hearing......................................................238
Anil K. Lalwani
35 Upper Respiratory Symptoms, Including Earache,
Sinus Symptoms, and Sore Throat...................................247
Rachel L. Amdur, Jeffrey A. Linder
36 Oral Manifestations of Disease.......................................256
Samuel C. Durso
SECTION 5 Alterations in Circulatory and
Respiratory Functions
37 Dyspnea.........................................................................263
Rebecca M. Baron
38 Cough............................................................................267
Christopher H. Fanta
39 Hemoptysis....................................................................270
Carolyn M. D’Ambrosio
40 Hypoxia and Cyanosis.....................................................272
Joseph Loscalzo
41 Edema............................................................................275
Joseph Loscalzo
42 Approach to the Patient with a Heart Murmur................278
Patrick T. O’Gara, Joseph Loscalzo
43 Palpitations.....................................................................286

SECTION 6 Alterations in Gastrointestinal Function
44 Dysphagia......................................................................287
Ikuo Hirano, Peter J. Kahrilas
45 Nausea, Vomiting, and Indigestion..................................291
William L. Hasler
46 Diarrhea and Constipation..............................................297
Michael Camilleri, Joseph A. Murray
47 Unintentional Weight Loss.............................................309
J. Larry Jameson
48 Gastrointestinal Bleeding................................................311
Loren Laine
49 Jaundice..........................................................................315
Savio John, Daniel S. Pratt
50 Abdominal Swelling and Ascites.....................................321
Lawrence S. Friedman
SECTION 7 Alterations in Renal and Urinary Tract
Function
51 Interstitial Cystitis/Bladder Pain Syndrome.....................325
R. Christopher Doiron, J. Curtis Nickel
52 Azotemia and Urinary Abnormalities..............................331
David B. Mount
53 Fluid and Electrolyte Disturbances.................................338
David B. Mount
54 Hypercalcemia and Hypocalcemia...................................356
Sundeep Khosla
55 Acidosis and Alkalosis.....................................................359
Thomas D. DuBose, Jr.
SECTION 8 Alterations in the Skin
56 Approach to the Patient with a Skin Disorder..................369
Kim B. Yancey, Thomas J. Lawley
57 Eczema, Psoriasis, Cutaneous Infections, Acne,
and Other Common Skin Disorders................................374
Leslie P. Lawley, Justin Cheeley, Robert A. Swerlick
58 Skin Manifestations of Internal Disease..........................383
Jean L. Bolognia, Jonathan S. Leventhal, Irwin M. Braverman
59 Immunologically Mediated Skin Diseases.......................400
Kim B. Yancey, Benjamin F. Chong, Thomas J. Lawley
60 Cutaneous Drug Reactions.............................................407
Robert G. Micheletti, Misha Rosenbach,
Bruce U. Wintroub, Kanade Shinkai
61 Photosensitivity and Other Reactions to Sunlight............417
Alexander G. Marneros, David R. Bickers
SECTION 9 Hematologic Alterations
62 Interpreting Peripheral Blood Smears..............................424
Dan L. Longo
63 Anemia and Polycythemia...............................................431
John W. Adamson, Dan L. Longo
64 Disorders of Granulocytes and Monocytes......................439
Steven M. Holland, John I. Gallin
65 Bleeding and Thrombosis................................................450
Barbara A. Konkle
66 Enlargement of Lymph Nodes and Spleen.......................457
Dan L. Longo
PART 3 Pharmacology
67 Principles of Clinical Pharmacology................................465
Dan M. Roden
68 Pharmacogenomics.........................................................474
Dan M. Roden
PART 4 Oncology and Hematology
SECTION 1 Neoplastic Disorders
69 Approach to the Patient with Cancer...............................481
Dan L. Longo
70 Prevention and Early Detection of Cancer.......................490
Jennifer M. Croswell, Otis W. Brawley,
Barnett S. Kramer
71 Cancer Genetics.............................................................498
Fred Bunz, Bert Vogelstein
72 Cancer Cell Biology........................................................508
Jeffrey W. Clark, Dan L. Longo
73 Principles of Cancer Treatment.......................................529
Edward A. Sausville, Dan L. Longo
74 Infections in Patients with Cancer...................................556
Robert W. Finberg
75 Oncologic Emergencies...................................................565
Rasim Gucalp, Janice P. Dutcher
76 Cancer of the Skin..........................................................578
Brendan D. Curti, John T. Vetto, Sancy A. Leachman
77 Head and Neck Cancer...................................................590
Everett E. Vokes
78 Neoplasms of the Lung...................................................594
Leora Horn, Wade T. Iams
79 Breast Cancer.................................................................611
Daniel F. Hayes, Marc E. Lippman
80 Upper Gastrointestinal Tract Cancers..............................626
David Kelsen
81 Lower Gastrointestinal Cancers......................................636
Robert J. Mayer
82 Tumors of the Liver and Biliary Tree...............................643
Josep M. Llovet
83 Pancreatic Cancer...........................................................657
Daniel D. Von Hoff
84 Gastrointestinal Neuroendocrine Tumors........................663
Matthew H. Kulke
85 Renal Cell Carcinoma.....................................................673
Robert J. Motzer, Martin H. Voss
86 Cancer of the Bladder and Urinary Tract..........................676
Noah M. Hahn
87 Benign and Malignant Diseases of the Prostate................681
Howard I. Scher, James A. Eastham
88 Testicular Cancer............................................................689
David J. Vaughn
89 Gynecologic Malignancies..............................................695
David Spriggs
90 Primary and Metastatic Tumors of the Nervous
System............................................................................701
Lisa M. DeAngelis, Patrick Y. Wen
91 Soft Tissue and Bone Sarcomas and Bone
Metastases......................................................................712

92 Carcinoma of Unknown Primary.....................................716
Kanwal Raghav, James L. Abbruzzese, Gauri R. Varadhachary
93 Paraneoplastic Syndromes: Endocrinologic/
Hematologic...................................................................721
J. Larry Jameson, Dan L. Longo
94 Paraneoplastic Neurologic Syndromes and
Autoimmune Encephalitis...............................................728
Josep Dalmau, Myrna R. Rosenfeld, Francesc Graus
95 Cancer Survivorship and the Long-Term Impact
of Cancer and Its Treatment............................................736
Mark Roschewski, Dan L. Longo
SECTION 2 Hematopoietic Disorders
96 Hematopoietic Stem Cells...............................................743
David T. Scadden, Dan L. Longo
97 Iron Deficiency and Other Hypoproliferative
Anemias.........................................................................747
John W. Adamson
98 Disorders of Hemoglobin................................................754
Martin H. Steinberg
99 Megaloblastic Anemias...................................................766
A. Victor Hoffbrand
100 Hemolytic Anemias........................................................776
Lucio Luzzatto, Lucia De Franceschi
101 Anemia Due to Acute Blood Loss...................................791
Dan L. Longo
102 Bone Marrow Failure Syndromes Including
Aplastic Anemia and Myelodysplasia...............................792
Neal S. Young
103 Polycythemia Vera and Other Myeloproliferative
Neoplasms......................................................................802
Jerry L. Spivak
104 Acute Myeloid Leukemia................................................809
William Blum
105 Chronic Myeloid Leukemia.............................................818
Hagop Kantarjian, Elias Jabbour, Jorge Cortes
106 Acute Lymphoid Leukemia.............................................828
Dieter Hoelzer
107 Chronic Lymphocytic Leukemia.....................................834
Jennifer A. Woyach, John C. Byrd
108 Non-Hodgkin’s Lymphoma............................................841
Caron A. Jacobson, Dan L. Longo
109 Hodgkin’s Lymphoma.....................................................852
Caron A. Jacobson, Dan L. Longo
110 Less Common Lymphoid and Myeloid
Malignancies..................................................................855
Ayalew Tefferi, Dan L. Longo
111 Plasma Cell Disorders.....................................................866
Nikhil C. Munshi, Dan L. Longo, Kenneth C. Anderson
112 Amyloidosis....................................................................878
John L. Berk, Vaishali Sanchorawala
113 Transfusion Therapy and Biology....................................884
Pierre Tiberghien, Olivier Garraud, Jacques Chiaroni
114 Hematopoietic Cell Transplantation................................897
Frederick R. Appelbaum
SECTION 3 Disorders of Hemostasis
115 Disorders of Platelets and Vessel Wall..............................903
Barbara A. Konkle
116 Coagulation Disorders....................................................910
Jean M. Connors
117 Arterial and Venous Thrombosis.....................................919
Jane E. Freedman, Joseph Loscalzo
118 Antiplatelet, Anticoagulant, and Fibrinolytic
Drugs.............................................................................924
Jeffrey I. Weitz
PART 5 Infectious Diseases
SECTION 1 Basic Considerations in Infectious Diseases
119 Approach to the Patient with an Infectious Disease..........941
Neeraj K. Surana, Dennis L. Kasper
120 Molecular Mechanisms of Microbial Pathogenesis...........948
Thomas E. Wood, Marcia B. Goldberg
121 Microbial Genomics and Infectious Disease....................960
Roby P. Bhattacharyya, Yonatan H. Grad, Deborah T. Hung
122 Approach to the Acutely Ill Infected Febrile Patient.........973
Tamar F. Barlam
123 Immunization Principles and Vaccine Use.......................981
Sarah Mbaeyi, Amanda Cohn, Nancy Messonnier
124 Health Recommendations for International Travel..........989
Jesse Waggoner, Henry M. Wu
125 Climate Change and Infectious Disease......................... 1001
Aaron S. Bernstein
SECTION 2 Clinical Syndromes:
Community-Acquired Infections
126 Pneumonia................................................................... 1009
Lionel A. Mandell, Michael S. Niederman
127 Lung Abscess................................................................ 1020
Rebecca M. Baron, Beverly W. Baron, Miriam Baron Barshak
128 Infective Endocarditis................................................... 1022
Sara E. Cosgrove, Adolf W. Karchmer
129 Infections of the Skin, Muscles, and Soft Tissues........... 1034
Dennis L. Stevens, Amy E. Bryant
130 Infectious Arthritis....................................................... 1040
Lawrence C. Madoff, Nongnooch Poowanawittayakom
131 Osteomyelitis................................................................ 1046
Werner Zimmerli
132 Intraabdominal Infections and Abscesses...................... 1054
Miriam Baron Barshak, Dennis L. Kasper
133 Acute Infectious Diarrheal Diseases and Bacterial
Food Poisoning............................................................. 1061
Richelle C. Charles, Regina C. LaRocque
134 Clostridioides difficile Infection, Including
Pseudomembranous Colitis........................................... 1066
Dale N. Gerding, Stuart Johnson
135 Urinary Tract Infections, Pyelonephritis, and
Prostatitis..................................................................... 1070
Kalpana Gupta, Barbara W. Trautner
136 Sexually Transmitted Infections: Overview and
Clinical Approach......................................................... 1078
Jeanne M. Marrazzo, King K. Holmes
137 Encephalitis.................................................................. 1094
Karen L. Roos, Michael R. Wilson, Kenneth L. Tyler
138 Acute Meningitis.......................................................... 1100
Karen L. Roos, Kenneth L. Tyler
CONTENTS
139 Chronic and Recurrent Meningitis................................ 1110 ix
Avindra Nath, Walter J. Koroshetz, Michael R. Wilson
140 Brain Abscess and Empyema......................................... 1117
Karen L. Roos, Kenneth L. Tyler
141 Infectious Complications of Bites.................................. 1124
Sandeep S. Jubbal, Florencia Pereyra Segal, Lawrence C. Madoff
SECTION 3 Clinical Syndromes: Health
Care–Associated Infections
142 Infections Acquired in Health Care Facilities................. 1128
Robert A. Weinstein
143 Infections in Transplant Recipients............................... 1136
Robert W. Finberg
SECTION 4 Therapy for Bacterial Diseases
144 Treatment and Prophylaxis of Bacterial Infections......... 1148
David C. Hooper, Erica S. Shenoy, Ramy H. Elshaboury
145 Bacterial Resistance to Antimicrobial Agents................ 1163
David C. Hooper
SECTION 5 Diseases Caused by Gram-Positive Bacteria
146 Pneumococcal Infections............................................... 1169
David Goldblatt, Katherine L. O’Brien
147 Staphylococcal Infections.............................................. 1178
Franklin D. Lowy
148 Streptococcal Infections................................................ 1188
Michael R. Wessels
149 Enterococcal Infections................................................. 1197
William R. Miller, Cesar A. Arias, Barbara E. Murray
150 Diphtheria and Other Corynebacterial Infections.......... 1203
William R. Bishai, John R. Murphy
151 Listeria monocytogenes Infections.................................... 1208
Jennifer P. Collins, Patricia M. Griffin
152 Tetanus......................................................................... 1211
C. Louise Thwaites, Lam Minh Yen
153 Botulism....................................................................... 1214
Carolina Lúquez, Jeremy Sobel
154 Gas Gangrene and Other Clostridial Infections............. 1220
Amy E. Bryant, Dennis L. Stevens
SECTION 6 Diseases Caused by Gram-Negative Bacteria
155 Meningococcal Infections............................................. 1225
Manish Sadarangani, Andrew J. Pollard
156 Gonococcal Infections.................................................. 1234
Sanjay Ram, Peter A. Rice
157 Haemophilus and Moraxella Infections............................ 1241
Timothy F. Murphy
158 Infections Due to the HACEK Group and
Miscellaneous Gram-Negative Bacteria......................... 1246
Tamar F. Barlam
159 Legionella Infections...................................................... 1249
Steven A. Pergam, Thomas R. Hawn
160 Pertussis and Other Bordetella Infections....................... 1257
Karina A. Top, Scott A. Halperin
161 Diseases Caused by Gram-Negative Enteric
Bacilli........................................................................... 1261
Thomas A. Russo, James R. Johnson
162 Acinetobacter Infections................................................. 1275
Rossana Rosa, L. Silvia Munoz-Price
163 Helicobacter pylori Infections.......................................... 1279
John C. Atherton, Martin J. Blaser
164 Infections Due to Pseudomonas, Burkholderia, and
Stenotrophomonas Species.............................................. 1284
Reuben Ramphal
165 Salmonellosis................................................................ 1291
David A. Pegues, Samuel I. Miller
166 Shigellosis..................................................................... 1298
Philippe J. Sansonetti, Jean Bergounioux
167 Infections Due to Campylobacter and Related
Organisms.................................................................... 1302
Martin J. Blaser
168 Cholera and Other Vibrioses......................................... 1305
Matthew K. Waldor, Edward T. Ryan
169 Brucellosis.................................................................... 1310
Nicholas J. Beeching
170 Tularemia..................................................................... 1314
Max Maurin, Didier Raoult
171 Plague and Other Yersinia Infections............................. 1320
Michael B. Prentice
172 Bartonella Infections, Including Cat-Scratch
Disease......................................................................... 1328
Michael Giladi, Moshe Ephros
173 Donovanosis................................................................. 1334
Nigel O’Farrell
SECTION 7 Miscellaneous Bacterial Infections
174 Nocardiosis................................................................... 1335
Gregory A. Filice
175 Actinomycosis............................................................... 1340
Thomas A. Russo
176 Whipple’s Disease......................................................... 1344
Thomas A. Russo, Seth R. Glassman
177 Infections Due to Mixed Anaerobic Organisms............. 1347
Neeraj K. Surana, Dennis L. Kasper
SECTION 8 Mycobacterial Diseases
178 Tuberculosis.................................................................. 1357
Mario C. Raviglione, Andrea Gori
179 Leprosy......................................................................... 1382
Jan H. Richardus, Hemanta K. Kar,
Zoica Bakirtzief, Wim H. van Brakel
180 Nontuberculous Mycobacterial Infections..................... 1392
Steven M. Holland
181 Antimycobacterial Agents............................................. 1397
Divya Reddy, Sebastian G. Kurz, Max R. O’Donnell
SECTION 9 Spirochetal Diseases
182 Syphilis......................................................................... 1406
Sheila A. Lukehart
183 Endemic Treponematoses............................................. 1413
Sheila A. Lukehart, Lorenzo Giacani
184 Leptospirosis................................................................ 1417
Jiři F. P. Wagenaar, Marga G.A. Goris
185 Relapsing Fever and Borrelia miyamotoi Disease............. 1421
Alan G. Barbour
186 Lyme Borreliosis........................................................... 1425
Allen C. Steere
CONTENTS
x SECTION 10 Diseases Caused by Rickettsiae, Mycoplasmas,
and Chlamydiae
187 Rickettsial Diseases....................................................... 1431
David H. Walker, J. Stephen Dumler, Lucas S. Blanton,
Chantal P. Bleeker-Rovers
188 Infections Due to Mycoplasmas.................................... 1441
R. Doug Hardy
189 Chlamydial Infections................................................... 1444
Charlotte A. Gaydos, Thomas C. Quinn
SECTION 11 Viral Diseases: General Considerations
190 Principles of Medical Virology...................................... 1453
David M. Knipe
191 Antiviral Chemotherapy, Excluding Antiretroviral
Drugs........................................................................... 1460
Jeffrey I. Cohen, Eleanor Wilson
SECTION 12 Infections Due to DNA Viruses
192 Herpes Simplex Virus Infections................................... 1470
Lawrence Corey
193 Varicella-Zoster Virus Infections................................... 1479
Richard J. Whitley
194 Epstein-Barr Virus Infections, Including Infectious
Mononucleosis............................................................. 1483
Jeffrey I. Cohen
195 Cytomegalovirus and Human Herpesvirus
Types 6, 7, and 8............................................................ 1487
Camille Nelson Kotton, Martin S. Hirsch
196 Molluscum Contagiosum, Monkeypox, and
Other Poxvirus Infections............................................. 1492
Inger K. Damon
197 Parvovirus Infections.................................................... 1495
Kevin E. Brown
198 Human Papillomavirus Infections................................. 1498
Darron R. Brown, Aaron C. Ermel
SECTION 13 Infections Due to DNA and RNA
Respiratory Viruses
199 Common Viral Respiratory Infections, Including
COVID-19................................................................... 1504
James E. Crowe, Jr.
200 Influenza...................................................................... 1515
Kathleen M. Neuzil, Peter F. Wright
SECTION 14 Infections Due to Human Immunodeficiency
Virus and Other Human Retroviruses
201 The Human Retroviruses.............................................. 1521
Dan L. Longo, Anthony S. Fauci
202 Human Immunodeficiency Virus Disease:
AIDS and Related Disorders......................................... 1527
Anthony S. Fauci, Gregory K. Folkers, H. Clifford Lane
SECTION 15 Infections Due to RNA Viruses
203 Viral Gastroenteritis..................................................... 1596
Umesh D. Parashar, Roger I. Glass
204 Enterovirus, Parechovirus, and Reovirus Infections....... 1601
Jeffrey I. Cohen
205 Measles (Rubeola)......................................................... 1607
Kaitlin Rainwater-Lovett, William J. Moss
206 Rubella (German Measles)............................................ 1611
Laura A. Zimmerman, Susan E. Reef
207 Mumps......................................................................... 1614
Jessica Leung, Mariel Marlow
208 Rabies and Other Rhabdovirus Infections..................... 1617
Alan C. Jackson
209 Arthropod-Borne and Rodent-Borne Virus
Infections..................................................................... 1623
Jens H. Kuhn, Ian Crozier
210 Ebolavirus and Marburgvirus Infections........................ 1644
Jens H. Kuhn, Ian Crozier
SECTION 16 Fungal Infections
211 Pathogenesis, Diagnosis, and Treatment of
Fungal Infections.......................................................... 1651
Michail S. Lionakis, John E. Edwards Jr.
212 Histoplasmosis............................................................. 1657
Chadi A. Hage, L. Joseph Wheat
213 Coccidioidomycosis...................................................... 1660
Neil M. Ampel
214 Blastomycosis............................................................... 1663
Gregory M. Gauthier, Bruce S. Klein
215 Cryptococcosis.............................................................. 1667
Arturo Casadevall
216 Candidiasis................................................................... 1670
Michail S. Lionakis, Shakti Singh, Ashraf S. Ibrahim,
John E. Edwards, Jr.
217 Aspergillosis................................................................. 1676
David W. Denning
218 Mucormycosis............................................................... 1680
Brad Spellberg, Ashraf S. Ibrahim
219 Less Common Systemic Mycoses and Superficial
Mycoses........................................................................ 1685
Carol A. Kauffman
220 Pneumocystis Infections................................................. 1690
Alison Morris, Henry Masur
SECTION 17 Protozoal and Helminthic Infections:
General Considerations
221 Introduction to Parasitic Infections............................... 1695
Sharon L. Reed
222 Agents Used to Treat Parasitic Infections....................... 1700
Thomas A. Moore
SECTION 18 Protozoal Infections
223 Amebiasis and Infection with Free-Living Amebae........ 1713
Rosa M. Andrade, Sharon L. Reed
224 Malaria......................................................................... 1719
Nicholas J. White, Elizabeth A. Ashley
225 Babesiosis..................................................................... 1735
Edouard Vannier, Jeffrey A. Gelfand
226 Leishmaniasis............................................................... 1740
Shyam Sundar
227 Chagas Disease and African Trypanosomiasis................ 1747
François Chappuis, Yves Jackson
228 Toxoplasma Infections................................................... 1756
Kami Kim
229 Protozoal Intestinal Infections and Trichomoniasis........ 1763
Peter F. Weller
CONTENTS
xi SECTION 19 Helminthic Infections
230 Introduction to Helminthic Infections........................... 1767
Peter F. Weller
231 Trichinellosis and Other Tissue Nematode
Infections..................................................................... 1769
Peter F. Weller
232 Intestinal Nematode Infections..................................... 1772
Thomas B. Nutman, Peter F. Weller
233 Filarial and Related Infections....................................... 1777
Thomas B. Nutman, Peter F. Weller
234 Schistosomiasis and Other Trematode Infections........... 1783
Birgitte Jyding Vennervald
235 Cestode Infections........................................................ 1789
A. Clinton White, Jr., Peter F. Weller
PART 6 Disorders of the Cardiovascular
System
SECTION 1 Introduction to Cardiovascular Disorders
236 Approach to the Patient with Possible
Cardiovascular Disease................................................. 1797
Joseph Loscalzo
237 Basic Biology of the Cardiovascular System................... 1799
Joseph Loscalzo, John F. Keaney, Jr., Calum A. MacRae
238 Epidemiology of Cardiovascular Disease....................... 1810
Thomas A. Gaziano, J. Michael Gaziano
SECTION 2 Diagnosis of Cardiovascular Disorders
239 Physical Examination of the Cardiovascular
System.......................................................................... 1815
Patrick T. O’Gara, Joseph Loscalzo
240 Electrocardiography...................................................... 1824
Ary L. Goldberger
241 Noninvasive Cardiac Imaging: Echocardiography,
Nuclear Cardiology, and Magnetic Resonance/
Computed Tomography Imaging................................... 1832
Marcelo F. DiCarli, Raymond Y. Kwong, Scott D. Solomon
242 Diagnostic Cardiac Catheterization and
Coronary Angiography................................................. 1859
Jane A. Leopold, David P. Faxon
SECTION 3 Disorders of Rhythm
243 Principles of Clinical Cardiac Electrophysiology............ 1866
William H. Sauer, Bruce A. Koplan, Paul C. Zei
244 The Bradyarrhythmias: Disorders of the
Sinoatrial Node............................................................. 1873
William H. Sauer, Bruce A. Koplan
245 The Bradyarrhythmias: Disorders of the
Atrioventricular Node................................................... 1880
William H. Sauer, Bruce A. Koplan
246 Approach to Supraventricular Tachyarrhythmias........... 1888
William H. Sauer, Paul C. Zei
247 Physiologic and Nonphysiologic Sinus Tachycardia........ 1891
William H. Sauer, Paul C. Zei
248 Focal Atrial Tachycardia................................................ 1893
William H. Sauer, Paul C. Zei
249 Paroxysmal Supraventricular Tachycardias..................... 1894
William H. Sauer, Paul C. Zei
250 Common Atrial Flutter and Macroreentrant and
Multifocal Atrial Tachycardias...................................... 1899
William H. Sauer, Paul C. Zei
251 Atrial Fibrillation......................................................... 1903
William H. Sauer, Paul C. Zei
252 Approach to Ventricular Arrhythmias............................ 1910
William H. Sauer, Usha B. Tedrow
253 Premature Ventricular Contractions, Nonsustained
Ventricular Tachycardia, and Accelerated
Idioventricular Rhythm................................................. 1915
William H. Sauer, Usha B. Tedrow
254 Sustained Ventricular Tachycardia................................. 1919
William H. Sauer, Usha B. Tedrow
255 Polymorphic Ventricular Tachycardia and
Ventricular Fibrillation................................................. 1923
William H. Sauer, Usha B. Tedrow
256 Electrical Storm and Incessant Ventricular
Tachycardia................................................................... 1927
William H. Sauer, Usha B. Tedrow
SECTION 4 Disorders of the Heart, Muscles,
Valves, and Pericardium
257 Heart Failure: Pathophysiology and Diagnosis............... 1930
Michael M. Givertz, Mandeep R. Mehra
258 Heart Failure: Management.......................................... 1940
Akshay S. Desai, Mandeep R. Mehra
259 Cardiomyopathy and Myocarditis.................................. 1954
Neal K. Lakdawala, Lynne Warner Stevenson, Joseph Loscalzo
260 Cardiac Transplantation and Prolonged Assisted
Circulation................................................................... 1973
Mandeep R. Mehra
261 Aortic Stenosis.............................................................. 1978
Patrick T. O’Gara, Joseph Loscalzo
262 Aortic Regurgitation..................................................... 1986
Patrick T. O’Gara, Joseph Loscalzo
263 Mitral Stenosis............................................................. 1991
Patrick T. O’Gara, Joseph Loscalzo
264 Mitral Regurgitation..................................................... 1995
Patrick T. O’Gara, Joseph Loscalzo
265 Mitral Valve Prolapse.................................................... 1999
Patrick T. O’Gara, Joseph Loscalzo
266 Tricuspid Valve Disease................................................. 2001
Patrick T. O’Gara, Joseph Loscalzo
267 Pulmonic Valve Disease................................................ 2004
Patrick T. O’Gara, Joseph Loscalzo
268 Multiple and Mixed Valvular Heart Disease.................. 2005
Patrick T. O’Gara, Joseph Loscalzo
269 Congenital Heart Disease in the Adult.......................... 2008
Anne Marie Valente, Michael J. Landzberg
270 Pericardial Disease........................................................ 2019
Joseph Loscalzo
271 Atrial Myxoma and Other Cardiac Tumors.................... 2025
Eric H. Awtry
272 Cardiac Trauma............................................................ 2028
Eric H. Awtry
SECTION 5 Coronary and Peripheral Vascular Disease
273 Ischemic Heart Disease................................................. 2030
Elliott M. Antman, Joseph Loscalzo
CONTENTS
xii 274 Non-ST-Segment Elevation Acute Coronary Syndrome
(Non-ST-Segment Elevation Myocardial Infarction
and Unstable Angina)................................................... 2046
Robert P. Giugliano, Christopher P. Cannon,
Eugene Braunwald
275 ST-Segment Elevation Myocardial Infarction............... 2053
Elliott M. Antman, Joseph Loscalzo
276 Percutaneous Coronary Interventions and Other
Interventional Procedures............................................. 2066
David P. Faxon, Deepak L. Bhatt
277 Hypertension................................................................ 2072
Theodore A. Kotchen
278 Renovascular Disease.................................................... 2088
Stephen C. Textor
279 Deep-Venous Thrombosis and Pulmonary
Thromboembolism....................................................... 2091
Samuel Z. Goldhaber
280 Diseases of the Aorta.................................................... 2101
Mark A. Creager, Joseph Loscalzo
281 Arterial Diseases of the Extremities............................... 2107
Mark A. Creager, Joseph Loscalzo
282 Chronic Venous Disease and Lymphedema................... 2115
Mark A. Creager, Joseph Loscalzo
283 Pulmonary Hypertension.............................................. 2121
Bradley A. Maron, Joseph Loscalzo
PART 7 Disorders of the Respiratory System
SECTION 1 Diagnosis of Respiratory Disorders
284 Approach to the Patient with Disease of the
Respiratory System....................................................... 2131
Bruce D. Levy
285 Disturbances of Respiratory Function........................... 2133
Edward T. Naureckas, Julian Solway
286 Diagnostic Procedures in Respiratory Disease............... 2140
George R. Washko, Hilary J. Goldberg, Majid Shafiq
SECTION 2 Diseases of the Respiratory System
287 Asthma......................................................................... 2147
Elliot Israel
288 Hypersensitivity Pneumonitis and Pulmonary
Infiltrates with Eosinophilia.......................................... 2160
Praveen Akuthota, Michael E. Wechsler
289 Occupational and Environmental Lung Disease............ 2166
John R. Balmes
290 Bronchiectasis............................................................... 2173
Rebecca M. Baron, Beverly W. Baron,
Miriam Baron Barshak
291 Cystic Fibrosis.............................................................. 2176
Eric J. Sorscher
292 Chronic Obstructive Pulmonary Disease....................... 2180
Edwin K. Silverman, James D. Crapo, Barry J. Make
293 Interstitial Lung Disease............................................... 2190
Gary M. Hunninghake, Ivan O. Rosas
294 Disorders of the Pleura.................................................. 2197
Richard W. Light
295 Disorders of the Mediastinum....................................... 2200
Richard W. Light
296 Disorders of Ventilation................................................ 2201
John F. McConville, Julian Solway, Babak Mokhlesi
297 Sleep Apnea.................................................................. 2204
Andrew Wellman, Daniel J. Gottlieb, Susan Redline
298 Lung Transplantation................................................... 2209
Hilary J. Goldberg, Hari R. Mallidi
299 Interventional Pulmonary Medicine............................... 2214
Lonny Yarmus, David Feller-Kopman
PART 8 Critical Care Medicine
SECTION 1 Respiratory Critical Care
300 Approach to the Patient with Critical Illness.................. 2217
Rebecca M. Baron, Anthony F. Massaro
301 Acute Respiratory Distress Syndrome........................... 2225
Rebecca M. Baron, Bruce D. Levy
302 Mechanical Ventilatory Support.................................... 2230
Scott Schissel
SECTION 2 Shock and Cardiac Arrest
303 Approach to the Patient with Shock.............................. 2235
Anthony F. Massaro
304 Sepsis and Septic Shock................................................ 2241
Emily B. Brant, Christopher W. Seymour, Derek C. Angus
305 Cardiogenic Shock and Pulmonary Edema.................... 2250
David H. Ingbar, Holger Thiele
306 Cardiovascular Collapse, Cardiac Arrest, and
Sudden Cardiac Death.................................................. 2257
Christine Albert, William H. Sauer
SECTION 3 Neurologic Critical Care
307 Nervous System Disorders in Critical Care.................... 2267
J. Claude Hemphill, III, Wade S. Smith, S. Andrew Josephson,
Daryl R. Gress
PART 9 Disorders of the Kidney and Urinary
Tract
308 Approach to the Patient with Renal Disease or
Urinary Tract Disease.................................................... 2279
Julian L. Seifter
309 Cell Biology and Physiology of the Kidney.................... 2287
Alfred L. George, Jr., Eric G. Neilson
310 Acute Kidney Injury...................................................... 2296
Sushrut S. Waikar, Joseph V. Bonventre
311 Chronic Kidney Disease................................................ 2309
Joanne M. Bargman, Karl Skorecki
312 Dialysis in the Treatment of Kidney Failure................... 2320
Kathleen D. Liu, Glenn M. Chertow
313 Transplantation in the Treatment of Renal Failure......... 2325
Jamil Azzi, Naoka Murakami, Anil Chandraker
314 Glomerular Diseases..................................................... 2331
Julia B. Lewis, Eric G. Neilson
315 Polycystic Kidney Disease and Other Inherited
Disorders of Tubule Growth and Development.............. 2350
Jing Zhou, Martin R. Pollak
316 Tubulointerstitial Diseases of the Kidney....................... 2357

317 Vascular Injury to the Kidney........................................ 2364
Ronald S. Go, Nelson Leung

318 Nephrolithiasis............................................................. 2368 xiii
Gary C. Curhan
319 Urinary Tract Obstruction............................................ 2373
Julian L. Seifter
320 Interventional Nephrology............................................ 2377
Dirk M. Hentschel
PART 10 Disorders of the Gastrointestinal
System
SECTION 1 Disorders of the Alimentary Tract
321 Approach to the Patient with Gastrointestinal
Disease......................................................................... 2381
William L. Hasler, Chung Owyang
322 Gastrointestinal Endoscopy.......................................... 2387
Louis Michel Wong Kee Song, Mark Topazian
323 Diseases of the Esophagus............................................. 2423
Peter J. Kahrilas, Ikuo Hirano
324 Peptic Ulcer Disease and Related Disorders................... 2434
John Del Valle
325 Disorders of Absorption................................................ 2458
Deborah C. Rubin
326 Inflammatory Bowel Disease......................................... 2469
Sonia Friedman, Richard S. Blumberg
327 Irritable Bowel Syndrome.............................................. 2490
Chung Owyang
328 Diverticular Disease and Common Anorectal
Disorders...................................................................... 2497
Susan L. Gearhart
329 Mesenteric Vascular Insufficiency.................................. 2506
Maryam Ali Khan, Jaideep Das Gupta, Mahmoud Malas
330 Acute Intestinal Obstruction......................................... 2508
Danny O. Jacobs
331 Acute Appendicitis and Peritonitis................................ 2513
Danny O. Jacobs
SECTION 2 Nutrition
332 Nutrient Requirements and Dietary Assessment............ 2517
Johanna T. Dwyer
333 Vitamin and Trace Mineral Deficiency and
Excess........................................................................... 2523
Paolo M. Suter
334 Malnutrition and Nutritional Assessment..................... 2534
Gordon L. Jensen
335 Enteral and Parenteral Nutrition................................... 2539
L. John Hoffer, Bruce R. Bistrian, David F. Driscoll
SECTION 3 Liver and Biliary Tract Disease
336 Approach to the Patient with Liver Disease................... 2546
Marc G. Ghany, Jay H. Hoofnagle
337 Evaluation of Liver Function......................................... 2553
Emily D. Bethea, Daniel S. Pratt
338 The Hyperbilirubinemias.............................................. 2557
Allan W. Wolkoff
339 Acute Viral Hepatitis.................................................... 2562
Jules L. Dienstag
340 Toxic and Drug-Induced Hepatitis................................ 2584
William M. Lee, Jules L. Dienstag
341 Chronic Hepatitis......................................................... 2591
Jules L. Dienstag
342 Alcohol-Associated Liver Disease................................. 2617
Bernd Schnabl
343 Nonalcoholic Fatty Liver Diseases and Nonalcoholic
Steatohepatitis.............................................................. 2619
Manal F. Abdelmalek, Anna Mae Diehl
344 Cirrhosis and Its Complications.................................... 2624
Alex S. Befeler, Bruce R. Bacon
345 Liver Transplantation.................................................... 2633
Raymond T. Chung, Jules L. Dienstag
346 Diseases of the
Gallbladder and Bile Ducts.............................................2641
Norton J. Greenberger, Gustav Paumgartner, Daniel S. Pratt
SECTION 4 Disorders of the Pancreas
347 Approach to the Patient with Pancreatic Disease............ 2652
Somashekar G. Krishna, Darwin L. Conwell, Phil A. Hart
348 Acute and Chronic Pancreatitis..................................... 2657
Phil A. Hart, Darwin L. Conwell, Somashekar G. Krishna
PART 11 Immune-Mediated, Inflammatory,
and Rheumatologic Disorders
SECTION 1 The Immune System in Health and Disease
349 Introduction to the Immune System.............................. 2671
Barton F. Haynes, Kelly A. Soderberg, Anthony S. Fauci
350 Mechanisms of Regulation and Dysregulation of the
Immune System............................................................ 2701
Barton F. Haynes, Kelly A. Soderberg, Anthony S. Fauci
351 Primary Immune Deficiency Diseases........................... 2709
Alain Fischer
SECTION 2 Disorders of Immune-Mediated Injury
352 Urticaria, Angioedema, and Allergic Rhinitis................. 2719
Katherine L. Tuttle, Joshua A. Boyce
353 Anaphylaxis.................................................................. 2727
David Hong, Joshua A. Boyce
354 Mastocytosis................................................................. 2729
Matthew P. Giannetti, Joshua A. Boyce
355 Autoimmunity and Autoimmune Diseases.................... 2731
Betty Diamond, Peter E. Lipsky
356 Systemic Lupus Erythematosus..................................... 2736
Bevra Hannahs Hahn, Maureen McMahon
357 Antiphospholipid Syndrome......................................... 2749
Haralampos M. Moutsopoulos, Clio P. Mavragani
358 Rheumatoid Arthritis.................................................... 2751
Ankoor Shah, E. William St. Clair
359 Acute Rheumatic Fever................................................. 2766
Joseph Kado, Jonathan Carapetis
360 Systemic Sclerosis (Scleroderma) and
Related Disorders......................................................... 2771
John Varga
361 Sjögren’s Syndrome....................................................... 2787
Haralampos M. Moutsopoulos, Clio P. Mavragani
362 Spondyloarthritis.......................................................... 2790
Joel D. Taurog, Lianne S. Gensler, Nigil Haroon
363 The Vasculitis Syndromes............................................. 2802
Carol A. Langford, Anthony S. Fauci
364 Behçet Syndrome.......................................................... 2817
Yusuf Yazici
CONTENTS
xiv 365 Inflammatory Myopathies............................................. 2819
Steven A. Greenberg, Anthony A. Amato
366 Relapsing Polychondritis............................................... 2826
Carol A. Langford
367 Sarcoidosis.................................................................... 2829
Robert P. Baughman, Elyse E. Lower
368 IgG4-Related Disease................................................... 2837
John H. Stone 126
369 Familial Mediterranean Fever and Other
Hereditary Autoinflammatory Diseases......................... 2840
Daniel L. Kastner
SECTION 3 Disorders of the Joints and Adjacent
Tissues
370 Approach to Articular and Musculoskeletal
Disorders...................................................................... 2844
John J. Cush
371 Osteoarthritis............................................................... 2854
David T. Felson, Tuhina Neogi
372 Gout and Other Crystal-Associated Arthropathies........ 2862
Hyon K. Choi
373 Fibromyalgia................................................................. 2868
Leslie J. Crofford
374 Arthritis Associated with Systemic Disease,
and Other Arthritides................................................... 2871
Carol A. Langford, Brian F. Mandell
375 Periarticular Disorders of the Extremities...................... 2878
Carol A. Langford
PART 12 Endocrinology and Metabolism
SECTION 1 Endocrinology
376 Approach to the Patient with Endocrine Disorders........ 2881
J. Larry Jameson
377 Mechanisms of Hormone Action.................................. 2884
J. Larry Jameson
378 Physiology of Anterior Pituitary Hormones.................. 2891
Shlomo Melmed, J. Larry Jameson
379 Hypopituitarism........................................................... 2896
Shlomo Melmed, J. Larry Jameson
380 Pituitary Tumor Syndromes.......................................... 2902
Shlomo Melmed, J. Larry Jameson
381 Disorders of the Neurohypophysis................................. 2918
Gary L. Robertson, Daniel G. Bichet
382 Thyroid Gland Physiology and Testing.......................... 2926
J. Larry Jameson, Susan J. Mandel, Anthony P. Weetman
383 Hypothyroidism............................................................ 2933
J. Larry Jameson, Susan J. Mandel, Anthony P. Weetman
384 Hyperthyroidism and Other Causes of
Thyrotoxicosis.............................................................. 2938
J. Larry Jameson, Susan J. Mandel, Anthony P. Weetman
385 Thyroid Nodular Disease and Thyroid Cancer............... 2946
J. Larry Jameson, Susan J. Mandel, Anthony P. Weetman
386 Disorders of the Adrenal Cortex.................................... 2955
Wiebke Arlt
387 Pheochromocytoma...................................................... 2976
Hartmut P. H. Neumann
388 Multiple Endocrine Neoplasia Syndromes..................... 2983
R. V. Thakker
389 Autoimmune Polyendocrine Syndromes........................ 2992
Peter A. Gottlieb, Aaron W. Michels
SECTION 2 Sex- and Gender-Based Medicine
390 Sex Development.......................................................... 2997
Courtney Finlayson, J. Larry Jameson, John C. Achermann
391 Disorders of the Testes and Male Reproductive
System.......................................................................... 3006
Shalender Bhasin, J. Larry Jameson
392 Disorders of the Female Reproductive System............... 3027
Janet E. Hall, Anuja Dokras
393 Menstrual Disorders and Pelvic Pain............................. 3033
Janet E. Hall, Anuja Dokras
394 Hirsutism..................................................................... 3039
David A. Ehrmann
395 Menopause and Postmenopausal Hormone
Therapy........................................................................ 3043
JoAnn E. Manson, Shari S. Bassuk
396 Infertility and Contraception........................................ 3050
Anuja Dokras, Janet E. Hall
397 Sexual Dysfunction....................................................... 3055
Kevin T. McVary
398 Women’s Health............................................................ 3063
Emily Nosova, Andrea Dunaif
399 Men’s Health................................................................ 3069
Shalender Bhasin
400 Lesbian, Gay, Bisexual, and Transgender
(LGBT) Health............................................................ 3078
Baligh R. Yehia, Zachary B. R. McClain
SECTION 3 Obesity, Diabetes Mellitus,
and Metabolic Syndrome
401 Pathobiology of Obesity................................................ 3080
Stephen O’Rahilly, I. Sadaf Farooqi
402 Evaluation and Management of Obesity........................ 3087
Robert F. Kushner
403 Diabetes Mellitus: Diagnosis, Classification,
and Pathophysiology..................................................... 3094
Alvin C. Powers, Kevin D. Niswender, Carmella Evans-Molina
404 Diabetes Mellitus: Management and Therapies...............3104
Alvin C. Powers, Michael J. Fowler, Michael R. Rickels
405 Diabetes Mellitus: Complications................................. 3120
Alvin C. Powers, John M. Stafford, Michael R. Rickels
406 Hypoglycemia............................................................... 3129
Stephen N. Davis, Philip E. Cryer
407 Disorders of Lipoprotein Metabolism........................... 3135
Daniel J. Rader
408 The Metabolic Syndrome.............................................. 3150
Robert H. Eckel
SECTION 4 Disorders of Bone and Mineral Metabolism
409 Bone and Mineral Metabolism in Health
and Disease................................................................... 3157
F. Richard Bringhurst, Henry M. Kronenberg, Eva S. Liu
410 Disorders of the Parathyroid Gland and Calcium
Homeostasis................................................................. 3169
John T. Potts, Jr., Harald Jüppner
411 Osteoporosis................................................................. 3191
Robert Lindsay, Blossom Samuels
CONTENTS
412 Paget’s Disease and Other Dysplasias of Bone............... 3209 xv
Rajesh K. Jain, Tamara J. Vokes
SECTION 5 Disorders of Intermediary Metabolism
413 Heritable Disorders of Connective Tissue...................... 3217
Joan C. Marini, Fransiska Malfait
414 Hemochromatosis......................................................... 3230
Lawrie W. Powell, David M. Frazer
415 Wilson’s Disease........................................................... 3235
Stephen G. Kaler
416 The Porphyrias............................................................. 3237
Robert J. Desnick, Manisha Balwani
417 Disorders of Purine and Pyrimidine Metabolism........... 3248
John N. Mecchella, Christopher M. Burns
418 Lysosomal Storage Diseases.......................................... 3254
Robert J. Hopkin, Gregory A. Grabowski
419 Glycogen Storage Diseases and Other Inherited
Disorders of Carbohydrate Metabolism......................... 3261
Priya S. Kishnani
420 Inherited Disorders of Amino Acid Metabolism
in Adults....................................................................... 3268
Nicola Longo
421 Inherited Defects of Membrane Transport.................... 3274
Nicola Longo
PART 13 Neurologic Disorders
SECTION 1 Diagnosis of Neurologic Disorders
422 Approach to the Patient with Neurologic Disease.......... 3277
Daniel H. Lowenstein, S. Andrew Josephson, Stephen L. Hauser
423 Neuroimaging in Neurologic Disorders......................... 3282
William P. Dillon
424 Pathobiology of Neurologic Diseases............................. 3293
Stephen L. Hauser, Arnold R. Kriegstein, Stanley B. Prusiner
SECTION 2 Diseases of the Central Nervous System
425 Seizures and Epilepsy.................................................... 3305
Vikram R. Rao, Daniel H. Lowenstein
426 Introduction to Cerebrovascular Diseases...................... 3324
Wade S. Smith, S. Claiborne Johnston, J. Claude Hemphill, III
427 Ischemic Stroke............................................................ 3335
Wade S. Smith, S. Claiborne Johnston, J. Claude Hemphill, III
428 Intracranial Hemorrhage............................................... 3348
Wade S. Smith, J. Claude Hemphill, III, S. Claiborne Johnston
429 Subarachnoid Hemorrhage........................................... 3353
J. Claude Hemphill, III,Wade S. Smith, Daryl R. Gress
430 Migraine and Other Primary Headache
Disorders...................................................................... 3357
Peter J. Goadsby
431 Alzheimer’s Disease...................................................... 3370
Gil D. Rabinovici, William W. Seeley, Bruce L. Miller
432 Frontotemporal Dementia............................................ 3378
William W. Seeley, Bruce L. Miller
433 Vascular Dementia........................................................ 3381
Steven M. Greenberg, William W. Seeley
434 Dementia with Lewy Bodies.......................................... 3385
Irene Litvan, William W. Seeley, Bruce L. Miller
435 Parkinson’s Disease....................................................... 3386
C. Warren Olanow, Anthony H.V. Schapira
436 Tremor, Chorea, and Other Movement Disorders........... 3400
C. Warren Olanow, Christine Klein
437 Amyotrophic Lateral Sclerosis and Other Motor
Neuron Diseases........................................................... 3410
Robert H. Brown, Jr.
438 Prion Diseases.............................................................. 3416
Stanley B. Prusiner, Michael Geschwind
439 Ataxic Disorders........................................................... 3422
Roger N. Rosenberg
440 Disorders of the Autonomic Nervous System...................3427
Richard J. Barohn, John W. Engstrom
441 Trigeminal Neuralgia, Bell’s Palsy, and Other
Cranial Nerve Disorders............................................... 3436
Vanja C. Douglas, Stephen L. Hauser
442 Diseases of the Spinal Cord........................................... 3445
Stephen L. Hauser
443 Concussion and Other Traumatic Brain Injuries............ 3456
Geoffrey T. Manley, Benjamin L. Brett, Michael McCrea
444 Multiple Sclerosis......................................................... 3462
Bruce A. C. Cree, Stephen L. Hauser
445 Neuromyelitis Optica.................................................... 3477
Bruce A. C. Cree, Stephen L. Hauser
SECTION 3 Nerve and Muscle Disorders
446 Peripheral Neuropathy.................................................. 3480
Anthony A. Amato, Richard J. Barohn
447 Guillain-Barré Syndrome and Other
Immune-Mediated Neuropathies................................... 3501
Stephen L. Hauser, Anthony A. Amato
448 Myasthenia Gravis and Other Diseases of the
Neuromuscular Junction............................................... 3509
Anthony A. Amato
449 Muscular Dystrophies and Other Muscle Diseases........ 3516
Anthony A. Amato, Robert H. Brown, Jr.
SECTION 4 Myalgic Encephalomyelitis/Chronic
Fatigue Syndrome
450 Myalgic Encephalomyelitis/Chronic Fatigue
Syndrome..................................................................... 3532
Elizabeth R. Unger, Jin-Mann S. Lin, Jeanne Bertolli
SECTION 5 Psychiatric and Addiction Disorders
451 Biology of Psychiatric Disorders.................................... 3534
Robert O. Messing, Eric J. Nestler, Matthew W. State
452 Psychiatric Disorders.................................................... 3540
Victor I. Reus
453 Alcohol and Alcohol Use Disorders............................... 3556
Marc A. Schuckit
454 Nicotine Addiction....................................................... 3563
David M. Burns
455 Marijuana and Marijuana
Use Disorders............................................................... 3567
Nora D. Volkow, Aidan Hampson, Ruben Baler
456 Opioid-Related Disorders............................................. 3569
Thomas R. Kosten, Colin N. Haile
457 Cocaine, Other Psychostimulants, and
Hallucinogens............................................................... 3573
Karran A. Phillips, Wilson M. Compton
CONTENTS
xvi PART 14 Poisoning, Drug Overdose,
and Envenomation
458 Heavy Metal Poisoning................................................. 3579
Howard Hu
459 Poisoning and Drug Overdose...................................... 3582
Mark B. Mycyk
460 Disorders Caused by Venomous Snakebites and
Marine Animal Exposures............................................. 3596
Erik Fisher, Alex Chen, Charles Lei
461 Ectoparasite Infestations and Arthropod Injuries.......... 3608
Richard J. Pollack, Scott A. Norton
PART 15 Disorders Associated with
Environmental Exposures
462 Altitude Illness............................................................. 3617
Buddha Basnyat, Geoffrey Tabin
463 Hyperbaric and Diving Medicine.................................. 3623
Michael H. Bennett, Simon J. Mitchell
464 Hypothermia and Peripheral Cold Injuries.................... 3630
Daniel F. Danzl
465 Heat-Related Illnesses.................................................. 3635
Daniel F. Danzl
PART 16 Genes, the Environment, and Disease
466 Principles of Human Genetics....................................... 3639
J. Larry Jameson, Peter Kopp
467 The Practice of Genetics in Clinical Medicine............... 3662
Susan M. Domchek, J. Larry Jameson, Susan Miesfeldt
468 Mitochondrial DNA and Heritable Traits and
Diseases........................................................................ 3668
Karl L. Skorecki, Bruce H. Cohen
469 Telomere Disease.......................................................... 3680
Rodrigo T. Calado, Neal S. Young
470 Gene- and Cell-Based Therapy in Clinical
Medicine...................................................................... 3685
Katherine A. High, Marcela V. Maus
471 The Human Microbiome.............................................. 3690
Neeraj K. Surana, Dennis L. Kasper
PART 17 Global Medicine
472 Global Issues in Medicine............................................. 3703
Joseph J. Rhatigan, Paul Farmer
473 Emerging and Reemerging Infectious Diseases.............. 3713
George W. Rutherford, Jaime Sepúlveda
474 Primary Care and Global Health................................... 3718
Tim Evans, Kumanan Rasanathan
475 Health Effects of Climate Change................................. 3726
Eugene T. Richardson, Maxine A. Burkett, Paul E. Farmer
PART 18 Aging
476 Biology of Aging........................................................... 3733
Rafael de Cabo, David Le Couteur
477 Caring for the Geriatric Patient..................................... 3739
Joseph G. Ouslander, Bernardo Reyes
PART 19 Consultative Medicine
478 Approach to Medical Consultation................................ 3761
Jeffrey Berns, Jack Ende
479 Medical Disorders During Pregnancy............................ 3762
Sarah Rae Easter, Robert L. Barbieri
480 Medical Evaluation of the Surgical Patient.................... 3769
Prashant Vaishnava, Kim A. Eagle
PART 20 Frontiers
481 Behavioral Economics and Health................................. 3775
Kevin G. Volpp, George Loewenstein, David A. Asch
482 Complementary and Integrative Therapies
and Practices................................................................. 3784
Helene M. Langevin
483 The Role of Epigenetics in Disease and Treatment........ 3790
Brian C. Capell, Shelley L. Berger
484 Applications of Stem Cell Biology in
Clinical Medicine......................................................... 3796
John A. Kessler
485 The Role of Circadian Biology in Health
and Disease................................................................... 3800
Jonathan Cedernaes, Kathryn Moynihan Ramsey, Joseph Bass
486 Network Medicine: Systems Biology in
Health and Disease....................................................... 3812
Joseph Loscalzo
487 Emerging Neurotherapeutic Technologies...................... 3819
Jyoti Mishra, Karunesh Ganguly
488 Machine Learning and Augmented Intelligence
in Clinical Medicine...................................................... 3826
Arjun K. Manrai, Isaac S. Kohane
489 Metabolomics............................................................... 3831
Jared R. Mayers, Mathew G. Vander Heiden
490 Circulating Nucleic Acids as Liquid Biopsies and
Noninvasive Disease Biomarkers................................... 3836
Ash A. Alizadeh, Kiran K. Khush, Yair J. Blumenfeld
491 Protein Folding Disorders............................................. 3846
Richard I. Morimoto, G. Scott Budinger
492 Novel Approaches to Diseases of
Unknown Etiology...........................................................3851
David Adams, Camilo Toro, Joseph Loscalzo
Index ........................................................................................I-1
Related Harrison’s 21st Edition Content
The following chapters are available online. They can be viewed by opening
the table of contents of Harrison’s 21st edition at www.accessmedicine.com/
harrisons.
Video Collection
V1 Video Library of Gait Disorders
Gail Kang, Nicholas B. Galifianakis, Michael D. Geschwind
V2 Primary Progressive Aphasia, Memory Loss, and Other Focal
Cerebral Disorders
Maria Luisa Gorno-Tempini, Jennifer Ogar, Joel Kramer, Bruce L. Miller,
Gil D. Rabinovici, Maria Carmela Tartaglia
V3 Video Library of Neuro-Ophthalmology
Jonathan C. Horton
V4 Examination of the Comatose Patient
S. Andrew Josephson
V5 Video Atlas of Gastrointestinal Endoscopic Lesions
Louis Michel Wong Kee Song, Mark Topazian
V6 The Neurologic Screening Exam
Daniel H. Lowenstein
V7 Video Atlas of the Detailed Neurologic Examination
Martin A. Samuels
Supplementary Topics
S1 Fluid and Electrolyte Imbalances and Acid-Base
Disturbances: Case Examples
David B. Mount, Thomas D. DuBose, Jr.
S2 Cerebrospinal Fluid Disturbances: Case Examples
Prashanth S. Ramachandran, Michael R. Wilson
S3 Microbial Bioterrorism
H. Clifford Lane, Anthony S. Fauci
S4 Chemical Terrorism
James A. Romano, Jr., Jonathan Newmark
S5 Radiation Terrorism
Christine E. Hill-Kayser, Eli Glatstein, Zelig A. Tochner
S6 Infections in War Veterans
Andrew W. Artenstein
S7 Health Care for Military Veterans
Stephen C. Hunt, Lucile Burgo-Black, Charles W. Hoge
S8 Primary Immunodeficiencies Associated with
(or Secondary to) Other Diseases
Alain Fischer
S9 Technique of Lumbar Puncture
Elizabeth Robbins, Stephen L. Hauser
S10 The Clinical Laboratory in Modern Health Care
Anthony A. Killeen
S11 Laboratory Diagnosis of Infectious Diseases
Manfred Brigl, Alexander McAdam
S12 Laboratory Diagnosis of Parasitic Infections
Sharon L. Reed, Sanjay R. Mehta
Atlases
A1 Atlas of Rashes Associated with Fever
Kenneth M. Kaye, Elaine T. Kaye
A2 Atlas of Blood Smears of Malaria and Babesiosis
Nicholas J. White, Elizabeth A. Ashley
A3 Atlas of Oral Manifestations of Disease
Samuel C. Durso, Janet A. Yellowitz
A4 Atlas of Urinary Sediments and Renal Biopsies
Agnes B. Fogo, Eric G. Neilson
A5 Atlas of Skin Manifestations of Internal Disease
Thomas J. Lawley, Benjamin K. Stoff, Calvin O. McCall
A6 Atlas of Hematology
Dan L. Longo
A7 Atlas of Electrocardiography
Ary L. Goldberger
A8 Atlas of Cardiac Arrhythmias
Ary L. Goldberger
A9 Atlas of Noninvasive Imaging
Marcelo F. Di Carli, Raymond Y. Kwong, Scott D. Solomon
A10 Atlas of Atherosclerosis
Peter Libby
A11 Atlas of Percutaneous Revascularization and Adult Structural
Heart Interventions
Jane A. Leopold, Deepak L. Bhatt, David P. Faxon
A12 Atlas of Chest Imaging
Samuel Y. Ash, George R. Washko
A13 Atlas of Liver Biopsies
Jules L. Dienstag, Atul K. Bhan
A14 Atlas of the Vasculitic Syndromes
Carol A. Langford, Anthony S. Fauci
A15 Atlas of Clinical Manifestations of Endocrine and Metabolic
Diseases
J. Larry Jameson
A16 Atlas of Neuroimaging
Michael F. Regner, Andre D. Furtado, Luciano Villarinho,
William P. Dillon
Preface
The Editors are pleased to present the 21st edition of Harrison’s Principles of
Internal Medicine. This 21st edition is a true landmark in medicine, spanning
71 years and multiple generations of trainees and practicing clinicians. While
medicine and medical education have evolved, readers will appreciate how
this classic textbook has retained enduring features that have distinguished
it among medical texts—a sharp focus on the clinical presentation of disease,
expert in-depth summaries of pathophysiology and treatment, and highlights
of emerging frontiers of science and medicine. Indeed, Harrison’s retains its
conviction that, in the profession of medicine, we are all perpetual students
with lifelong learning as our common goal.
Harrison’s is intended for learners throughout their careers. For students,
Part 1, Chapter 1 begins with an overview of “The Practice of Medicine.” In
this introductory chapter, the editors continue the tradition of orienting clinicians
to the science and the art of medicine, emphasizing the values of our
profession while incorporating new advances in technology, science, and clinical
care. Part 2, “Cardinal Manifestations and Presentation of Diseases,” is a
signature feature of Harrison’s. These chapters eloquently describe how patients
present with common clinical conditions, such as headache, fever, cough, palpitations,
or anemia, and provide an overview of typical symptoms, physical
findings, and differential diagnosis. Mastery of these topics prepares students
for subsequent chapters on specific diseases they will encounter in courses on
pathophysiology and in clinical clerkships. For residents and fellows caring for
patients and preparing for board examinations, Harrison’s remains a definitive
source of trusted content written by internationally renowned experts. Trainees
will be reassured by the depth of content, comprehensive tables, and illuminating
figures and clinical algorithms. Many examination questions are based
on key testing points derived from Harrison’s chapters. A useful companion
book, Harrison’s Self-Assessment and Board Review, includes over 1000 questions,
offers comprehensive explanations of the correct answer, and provides
links to the relevant chapters in the textbook. Practicing clinicians must keep
up with an ever-changing knowledge base and clinical guidelines as part of lifelong
learning. Clinicians can trust that chapters are updated extensively with
each edition of Harrison’s. The text is an excellent point-of-care reference for
clinical questions, differential diagnosis, and patient management. In addition
to the expanded and detailed Treatment sections, Harrison’s continues its tradition
of including “Approach to the Patient” sections, which provide an expert’s
overview of the practical management of common but often complex clinical
conditions.
This edition has been modified extensively in its structure as well as its content
and offers a more consistently standardized format for each disease chapter.
The authors and editors have curated rigorously and synthesized the vast amount
of information that comprises general internal medicine—and each of the major
specialties—into a highly readable and informative two-volume book. Readers
will appreciate the concise writing style and substantive quality that have always
characterized Harrison’s. This book has a sharp focus on essential information
with a goal of providing clear and definitive answers to clinical questions.
In the 21st edition, examples of new chapters include “Precision Medicine
and Clinical Care,” focusing on the ever-growing pool of “big data” used to provide
individualized genotype-phenotype correlations; “Mechanisms of Regulation
and Dysregulation of the Immune System,” focusing on the extraordinary
advances made over the past 5 years in understanding the complex and subtle
mechanisms whereby the immune system is regulated and how perturbations
in this regulation lead to disease states as well as targets for therapeutic intervention;
new chapters on Alzheimer’s disease and related conditions, with a
special focus on vascular dementia, a common and treatable cause of cognitive
loss; and a new chapter on marijuana and marijuana use disorders, as well as
updated management guidelines for multiple sclerosis and the expanding array
of other autoimmune nervous system diseases that can now be identified and
treated.
Other new chapters include “Vaccine Opposition and Hesitancy,” “Precision
Medicine and Clinical Care,” “Diagnosis: Reducing Errors and Improving
Quality,” “Approach to the Patient with Renal or Urinary Tract Disease,” “Interventional
Nephrology,” “Health Effects of Climate Change,” and “Circulating
Nucleic Acids as Liquid Biopsies and Noninvasive Disease Biomarkers.” In
addition, many chapters have new authors.
The chapter, “Vaccine Opposition and Hesitancy,” provides an overview of
the current antivaccination crisis, the issues involved, and specific strategies to
utilize within the clinical setting to address the lack of confidence that many
patients feel toward the health care system. The chapter, “Metabolomics,” outlines
an emerging and important new and sensitive approach to measuring perturbations
within a system or patient that will likely become a routine part of
the clinical armamentarium for diagnosing, monitoring, and treating disease.
In addition to these and other new topics, the 21st edition presents important
updates in the established chapters, such as the microbiology and clinical
management of SARS-CoV-2 infection, the use of gene editing for sickle cell
anemia and thalassemia, gene therapy for hemophilia, new immunotherapies
for autoimmune diseases and cancers, and novel approaches to vaccine
development, among many others. Our focus on forwarding-looking issues
of emerging clinical importance continues with the series of chapters entitled
“Frontiers,” which foreshadows cutting-edge science that will change medical
practice in the near term. Examples of new Frontier chapters include “Machine
Learning and Augmented Intelligence,” “Metabolomics,” “Protein Folding Disorders,”
and “Novel Approaches to Disease of Unknown Etiology.”
Harrison’s content is available in a variety of print and digital formats,
including eBooks, apps, and a popular, widely used online platform available
at www.accessmedicine.com.
We have many people to thank for their efforts in producing this book. First,
the authors have done a superb job of producing authoritative chapters that
synthesize vast amounts of scientific and clinical data to create informative and
practical approaches to managing patients. In today’s information-rich, rapidly
evolving environment, they have ensured that this information is current. We
are most grateful to our colleagues who work closely with each editor to facilitate
communication with the authors and help us keep Harrison’s content current.
In particular, we wish to acknowledge the expert support of Lauren Bauer,
Patricia Conrad, Patricia L. Duffey, Gregory K. Folkers, Julie B. McCoy, Elizabeth
Robbins, Marie Scurti, and Stephanie C. Tribuna. Scott Grillo and James
Shanahan, our long-standing partners at McGraw Hill’s Professional Publishing
group, have inspired the creative and dynamic evolution of Harrison’s,
guiding the development of the book and its related products in new formats.
Kim Davis, as Managing Editor, has adeptly ensured that the complex production
of this multi-authored textbook proceeded smoothly and efficiently.
Priscilla Beer oversaw the production of our videos and animations; Jeffrey
Herzich, Elleanore Waka, and Rachel Norton, along with other members of the
McGraw Hill staff; and Revathi Viswanathan of KnowledgeWorks Global Ltd.,
shepherded the production of this new edition.
We are privileged to have compiled this 21st edition and are enthusiastic
about all that it offers our readers. We learned much in the process of editing
Harrison’s and hope that you will find this edition uniquely valuable as a clinical
and educational resource.
The Editors
Related Harrison’s Resources
A complete collection to meet your educational, clinical, and board prep needs.
Harrison’s Online
The online edition of Harrison’s is available at www.accessmedicine.com. It requires an institutional or individual subscription separate from the purchase of the
print book. The online edition of Harrison’s features all the chapters from the print edition, plus more than two dozen supplementary chapters in print, atlas, and
video formats. Harrison’s Online includes numerous monthly updates, from the editors of Harrison’s, on important new developments in medical research and
practice. Easily search across the entire Harrison’s content set, download images and tables for presentations and lectures, view step-by-step videos on common
clinical procedures, access the text of the Harrison’s Manual of Medicine, set up a personalized test exam for board prep, get access to chapters from new editions
of Harrison’s months before book publication, and more.
The Harrison’s Manual of Medicine
The Harrison’s Manual of Medicine provides high-yield, rapid-access clinical summaries of Harrison’s content, suitable for use at the bedside. Chapters in the Manual
reflect those likely to be encountered in both the inpatient and outpatient setting. The format is built for ease of use. The Manual is available in print, eBook,
and app. In addition, the full text of the Manual is available to subscribers at accessmedicine.com. This format provides flexibility of format to customers, who can
move back and forth between the full scope of Harrison’s Principles of Internal Medicine and the high-yield clinical essentials of the Manual.
The Manual includes more than 200 chapters in 17 sections and covers presenting signs and symptoms and major conditions seen in both inpatient and outpatient
settings. The full table of contents is available at www.accessmedicine.com.
The Harrison’s Self-Assessment and Board Review
This practical resource provides more than 1000 self-assessment questions, most in board-style clinical vignette format with multiple choice answers. The explanations
for the questions are comprehensive and provide detailed guidance on correct and incorrect answers. Question-and-answer sets include references to related
chapters in Harrison’s Principles of Internal Medicine for more comprehensive understanding. Use this very handy resource for primary and recertification exam
prep, for rotational shelf exams, and for general assessment of understanding of the principles of clinical medicine. This resource is available as a print book, an
eBook, an app, and on accessmedicine.com, where users can create personalized testing experiences and receive instant scores on practice tests.
Harrison’s Podclass
Our podcast presents bi-weekly episodes covering clinical vignettes across internal medicine, with two expert discussants reviewing common and challenging
patient presentations and a series of self-assessment Q&A choices tied to each case. The hosts work through correct and incorrect answer choices and summarize
cases with practical pearls that all students and clinicians will find helpful and interesting. Harrison’s Podclass is available in most of the common podcast outlets
and on www.accessmedicine.com.



Write a review

Note: HTML is not translated!
Bad Good