What should be the Logical Approach to the Diagnosis of Infectious Disease?
Patients present with syndromes, not diagnoses. For example, one of the causes of headaches is meningitis, which can itself be caused by a variety of specific bacteria, viruses, fungi or parasites. The final etiologic diagnosis therefore becomes bacterial meningitis or viral meningitis, etc each with different therapeutic options and differing prognoses. Likewise diarrhea with fever can be caused by pathogens from different phyla. An attending clinician, who may lack the knowledge to request searches for specific pathogens, should not be expected to ask the laboratory to identify all the potential pathogens by name and then have the laboratory search for each of them. It would be much more appropriate (and frankly a reflection of everyday reality in medical practice) for the clinician to request the “Meningitis Test” or the “Infectious Diarrhea Test” and leave it up to the laboratory to look for ALL the potential pathogens regardless of their phyla. Unfortunately such comprehensive Syn
