Dr. Ferguson is a board certified Infectious Disease specialist. She specializes in the treatment of immunocompromised patients, including patients who have undergone bone marrow or solid organ transplantation and patients with hematologic or solid malignancies on chemotherapy.
- Immunocompromised Host
- Infectious Disease
Clinical Assistant Professor, Medicine - Infectious Diseases
Board Certification: American Board of Internal Medicine, Infectious Disease (2020)
Board Certification: American Board of Internal Medicine, Internal Medicine (2018)
Fellowship, Stanford University Infectious Disease Fellowships, Immunocompromised Infectious Diseases (2021)
Fellowship: Stanford University Infectious Disease Fellowships (2021) CA
Residency: Stanford University Internal Medicine Residency (2018) CA
Medical Education: UCLA David Geffen School Of Medicine Registrar (2015) CA
BS, University of California, San Diego, Molecular Biology (2011)
Use of a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) strand-specific assay to evaluate for prolonged viral replication >20 days from illness onset.
Infection control and hospital epidemiology
Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (rRT-PCR) strand-specific assay can be used to identify active SARS-CoV-2 viral replication. We describe the characteristics of 337 hospitalized patients with at least 1 minus-strand SARS-CoV-2 assay performed >20 days after illness onset. This test is a novel tool to identify high-risk hospitalized patients with prolonged SARS-CoV-2 replication.
View details for DOI 10.1017/ice.2023.105
View details for PubMedID 37381726
Cutaneous lesions in a solid organ transplant recipient: A Diagnostic Dilemma.
Transplant infectious disease : an official journal of the Transplantation Society
INTRODUCTION: This case involves a 66-year-old female with history of renal transplant in 1999 presenting with fevers and diffuse, painful ulcerative skin lesions. This article is protected by copyright. All rights reserved.
View details for DOI 10.1111/tid.13918
View details for PubMedID 35912460
- Lack of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission from a healthcare worker to a cohort of immunosuppressed patients during the SARS-CoV-2 omicron variant surge, California, 2022. Infection control and hospital epidemiology 2022: 1-2
Cutaneous cytomegalovirus - A case of disseminated cytomegalovirus presenting with extensive ulcerative skin lesions in a renal transplant recipient.
Transplant infectious disease : an official journal of the Transplantation Society
Cytomegalovirus (CMV) reactivation is common in organ transplant recipients and can lead to significant morbidity and mortality. Cutaneous CMV findings are rarely reported in the literature and diagnosis can be delayed if not clinically recognized. We describe a case of a female patient 20 years post renal transplant who presented with extensive ulcerative skin lesions and diarrhea. She rapidly deteriorated and died on day 5 of hospitalization. Autopsy noted extensive CMV involvement of skin and gastrointestinal (GI) tract by CMV-specific immunohistochemistry.
View details for DOI 10.1111/tid.13582
View details for PubMedID 33533137
Reactivation of Chagas Disease in a Patient With an Autoimmune Rheumatic Disease: Case Report and Review of the Literature.
Open forum infectious diseases
2021; 8 (2): ofaa642
Reactivation of Chagas disease has been described in immunosuppressed patients, but there is a paucity of literature describing reactivation in patients on immunosuppressive therapies for the treatment of autoimmune rheumatic diseases. We describe a case of Chagas disease reactivation in a woman taking azathioprine and prednisone for limited cutaneous systemic sclerosis (lcSSc). Reactivation manifested as indurated and erythematous cutaneous nodules. Sequencing of a skin biopsy specimen confirmed the diagnosis of Chagas disease. She was treated with benznidazole with clinical improvement in the cutaneous lesions. However, her clinical course was complicated and included disseminated CMV disease and subsequent septic shock due to bacteremia. Our case and review of the literature highlight that screening for Chagas disease should be strongly considered for patients who will undergo immunosuppression for treatment of autoimmune disease if epidemiologically indicated.
View details for DOI 10.1093/ofid/ofaa642
View details for PubMedID 33575423
View details for PubMedCentralID PMC7863873
Interferon-gamma release assay testing to assess COVID-19 vaccination response in a SARS-CoV-2 seronegative patient on rituximab: a case report.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
We describe the case of a 44-year-old female on Rituximab for treatment of multiple sclerosis with undetectable SARS-CoV-2 IgG specific antibodies eighteen days after second dose of SARS-CoV-2 vaccine. Interferon-gamma release assay testing for SARS-CoV-2 was positive on day nineteen, demonstrating robust T-cell mediated response despite lack of antibody-mediated response.
View details for DOI 10.1016/j.ijid.2021.06.054
View details for PubMedID 34216738
Characteristics and outcomes of coronavirus disease patients under nonsurge conditions, northern California, USA, March–April 2020
Emerging Infectious Diseases
Limited data are available on the clinical presentation and outcomes of coronavirus disease (COVID-19) patients in the United States hospitalized under normal-caseload or nonsurge conditions. We retrospectively studied 72 consecutive adult patients hospitalized with COVID-19 in 2 hospitals in the San Francisco Bay area, California, USA, during March 13-April 11, 2020. The death rate for all hospitalized COVID-19 patients was 8.3%, and median length of hospitalization was 7.5 days. Of the 21 (29% of total) intensive care unit patients, 3 (14.3% died); median length of intensive care unit stay was 12 days. Of the 72 patients, 43 (59.7%) had underlying cardiovascular disease and 19 (26.4%) had underlying pulmonary disease. In this study, death rates were lower than those reported from regions of the United States experiencing a high volume of COVID-19 patients.
View details for DOI 10.3201/eid2608.201776
- Appropriate Vancomycin Use and Incidence of Vancomycin-Resistant Enterococci in Liver Transplant Recipients OBM Transplantation 2020; 4 (4)
Attitudes and potential barriers towards hepatitis C treatment in patients with and without HIV coinfection
INTERNATIONAL JOURNAL OF STD & AIDS
2018; 29 (4): 334-340
This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.
View details for DOI 10.1177/0956462417725462
View details for Web of Science ID 000424648100003
View details for PubMedID 28820346
View details for PubMedCentralID PMC5670019
Viral Breakthrough Is Associated With Resistance Using Direct Acting Agents in Patients Treated for Chronic Hepatitis C Infection
JOURNAL OF CLINICAL GASTROENTEROLOGY
2014; 48 (6): 548-552
Despite improved virologic response with the addition of direct acting agents to peginterferon and ribavirin treatment in chronic hepatitis C virus (HCV) genotype 1 infection, a subset of patients experience viral breakthrough while on therapy. Defining viral breakthrough and patient characteristics is important for ongoing and future HCV treatment.Thirty-four patients treated with telaprevir between June 2011 and July 2012 were retrospectively evaluated for presence of viral breakthrough. Baseline patient characteristics, time to viral breakthrough, and HCV resistance patterns were determined.Viral breakthrough was seen in 26.5% of patients treated. Eight of 9 patients experienced breakthrough in the peginterferon and ribavirin-only phase of treatment with mean (±SD) time to breakthrough of 21.3 (±6.4) weeks. Viral breakthrough was more frequently seen in patients with genotype 1a, advanced liver fibrosis, and prior null treatment response. A majority of patients had presence of resistant mutations upon testing.A significant proportion of patients experience viral breakthrough after completion of the direct acting agent portion of triple therapy. More frequent virologic assessments during the peginterferon and ribavirin treatment phase may be necessary to reduce cost and adverse effects of treatment.
View details for DOI 10.1097/MCG.0b013e3182a8824c
View details for Web of Science ID 000337729500016
View details for PubMedID 24045279