- Pediatric Infectious Diseases
Clinical Assistant Professor, Pediatrics - Infectious Diseases
Associate Medical Director, Antimicrobial Stewardship Program, Lucile Packard Children's Hospital (2023 - Present)
Co-chair, Integrated Infectious Disease Program, Lucile Packard Children's Hospital (2023 - Present)
Honors & Awards
Tashia and John Morgridge Endowed Postdoctoral Fellow, Stanford Maternal & Child Health Research Institute (MCHRI) (2021)
Outpatient Fellow of the Year Teaching Award, Lucile Packard Children's Hospital at Stanford (2021)
Hugh O’Brodovich Excellence in Scholarship Award, Lucile Packard Children’s Hospital at Stanford (2017)
Appointed Member, Alpha Omega Alpha (AOA) Honor Medical Society (2016)
Boards, Advisory Committees, Professional Organizations
Appointed Member, Pediatric Infectious Diseases Society (PIDS) Education Committee (2022 - Present)
Fellowship, Stanford University School of Medicine / Lucile Packard Children's Hospital, Pediatric Infectious Diseases (2023)
Board Certification, American Board of Pediatrics, Pediatrics (2020)
Residency, Stanford University School of Medicine / Lucile Packard Children's Hospital, Pediatrics (2020)
Medical Education (MD), UC Irvine School of Medicine (2017)
Bachelor's Degree, UC Berkeley, Molecular and Cell Biology - Immunology/Infectious Diseases (2010)
Laying the Groundwork for a Fulfilling Career in Pediatric Infectious Diseases: The Transition from Fellowship to Faculty.
Journal of the Pediatric Infectious Diseases Society
There are limited resources for guidance on the transition from fellowship into a new faculty role in pediatric infectious diseases. This review aims to address this gap and provides a framework for a successful transition that is composed of four essential pillars-1) stepping into your role, 2) finding your niche, 3) building your network, and 4) self-care-all of which are supported by strong mentorship/sponsorship and continual re-alignment with one's personal mission statement. In addition to providing general principles and guidance, this review also outlines specific steps that a junior faculty member can take to expand their influence and build a successful, fulfilling career in pediatric infectious diseases.
View details for DOI 10.1093/jpids/piad079
View details for PubMedID 37815429
Impact of cell-free DNA fungal polymerase chain reaction panels on healthcare-associated infection mould investigations.
Journal of infection prevention
2023; 24 (5): 223-227
Launch of in-house sensitive cell-free deoxyribonucleic acid (cfDNA) mould polymerase chain reaction (PCR) assays increased detection of moulds meeting suspected healthcare-associated infection (HAI) criteria. Definition was based on time from admission and mould detection in culture or via molecular methods. We created a modified mould HAI algorithm incorporating clinical context into the case definition, which allowed for better capture of possible mould HAIs, decreased number of investigations, and improved utilization of Infection Prevention and Control (IPC) resources.
View details for DOI 10.1177/17571774231197603
View details for PubMedID 37736124
- Successful nasoenteric administration of glecaprevir/pibrentasvir for donor-derived hepatitis C in two young adult heart transplant recipients at a pediatric transplant center. Pediatric transplantation 2022: e14360
Vaccine-Associated Measles Encephalitis in Immunocompromised Child, California, USA.
Emerging infectious diseases
2022; 28 (4): 906-908
We report a fatal case of vaccine-associated measles encephalitis in an immunocompromised child in California, USA. The infection was confirmed by whole-genome RNA sequencing of measles virus from brain tissue. We observed biased matrix-gene hypermutation consistent with persistent measles virus central nervous system infection.
View details for DOI 10.3201/eid2804.212357
View details for PubMedID 35318930
- "For COVID" or "With COVID": Classification of SARS-CoV-2 Hospitalizations in Children. Hospital pediatrics 2021
- Assessment of Sensitivity and Specificity of Patient-Collected Lower Nasal Specimens for Sudden Acute Respiratory Syndrome Coronavirus 2 Testing. JAMA network open 2020; 3 (6): e2012005
Oral Antibiotics for Treating Children With Community-Acquired Pneumonia Complicated by Empyema.
No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment. We conducted a retrospective cohort study of patients discharged (2006-2016) with CAP-Em. Primary outcome measured was treatment success (no change in antibiotics or readmission to hospital for treatment of CAP-Em). White blood cell (WBC) count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) serial measurements were identified. Success was achieved in 133/144 (92.4%) O-Abx and 7/12 (58%) OPAT patients ( P = .0031). WBC and CRP decreased early; and ESR increased initially (admit and switch to O-Abx) and decreased by end of treatment. O-Abx is the modality of choice for treatment of CAP-Em after hospital discharge. WBC and CRP are useful to monitor success of O-Abx switch; and ESR provides guidance for length of treatment.
View details for DOI 10.1177/0009922819850494
View details for PubMedID 31122051
Acute and chronic immune biomarker changes during interferon/ribavirin treatment in HIV/HCV co-infected patients
JOURNAL OF VIRAL HEPATITIS
2015; 22 (1): 25-36
Chronic viral infections lead to persistent immune activation, which is alleviated by eradicating or suppressing the infection. To understand the effects of interferon treatment on immune system activation by chronic infections, we evaluated kinetic patterns of a broad spectrum of serum biomarkers during HCV treatment in HIV/HCV co-infected patients. HCV viral load and 50 biomarkers were analysed at baseline and 27 time points during pegylated interferon-alpha and ribavirin (IFN/RBV) treatment of 12 HIV/HCV co-infected patients. We evaluated biomarker changes from baseline for each time point and biomarker correlations with clinical parameters, treatment response and liver histopathology. IL-1α, IL-12p40, IL-1RA, IP-10, MIG, MIP-1α/1β, HGF, sCD40L, TRAIL and leptin increased in the first day. IL-12p70, IL-17A, IL-10, GROα, IL-8, MCP-3, IL-4 and M-CSF peaked later during week 1. IL-1α, HGF, IP-10, MIP-1α, TRAIL, sCD40L, IL-10, IL-12p70, MCP-3, FGFb, ENA-78, TGF-β, IL-2, IFN-γ, IL-6, IL-15, IL-7 and PDGF-BB decreased below baseline over the course of treatment. Higher BMI, baseline HCV viral load and leptin levels were associated with lack of sustained virologic response. ENA-78 was associated with sustained viral response. Positive correlations were found between liver inflammation and baseline CD4 count, sVCAM and HGF; fibrosis stage and HGF; liver steatosis, BMI and leptin. Our findings suggest IFN/RBV treatment initially increases levels of several biomarkers, but eventually leads to a decline in many immune markers. These findings shed light on the relationship between IFN treatment and immune activation by chronic viral infections, such as HCV.
View details for DOI 10.1111/jvh.12226
View details for Web of Science ID 000346826600005
View details for PubMedID 24506344
A feasibility study to determine if minimally trained medical students can identify markers of chronic parasitic infection using bedside ultrasound in rural Tanzania
WORLD JOURNAL OF EMERGENCY MEDICINE
2015; 6 (4): 293-298
Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided.Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient's liver, bladder, kidneys, and spleen.A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel.Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections.
View details for DOI 10.5847/wjem.j.1920-8642.2015.04.008
View details for Web of Science ID 000382242900008
View details for PubMedID 26693265
View details for PubMedCentralID PMC4677073
- Immune biomarker differences and changes comparing HCV mono-infected, HIV/HCV co-infected, and HCV spontaneously cleared patients. PloS one 2013; 8 (4)