- Pediatric Infectious Diseases
Clinical Assistant Professor, Pediatrics - Infectious Diseases
Board Certification: Pediatric Infectious Diseases, American Board of Pediatrics (2015)
Fellowship:Columbia University Medical Center (2014) NY
Residency:Kaiser Permanente Medical Center - Oakland (2010) CA
Medical Education:University of Illinois at Chicago College of Medicine (2007) IL
Board Certification: Pediatrics, American Board of Pediatrics (2010)
Diagnostic yield of bronchoalveolar lavage in immunocompromised children with malignant and non-malignant disorders.
The diagnostic yield of bronchoalveolar lavage (BAL) in the Immunocompromised pediatric population has ranged from 28% to 68%. We hypothesized that the diagnostic yield of BALs would be higher in more recent years due to new diagnostic assays.A retrospective case series was performed among immunocompromised children ≤18 years old who underwent BALs from 2001 to 2012, to assess the yield of microbiologic diagnostic studies and to determine the impact of BAL findings on antimicrobial management.In all, 123 subjects underwent 174 BALs (mean age 9.9 years). Underlying diagnoses included both malignant (n = 79) and non-malignant (n = 44) disorders, and 75 (61.0%) subjects were hematopoietic stem cell transplant (HSCT) recipients. Fifty-four (31.0%) of 174 BAL were positive for ≥1 potential pathogen (n = 58 microorganisms). The diagnostic yield of BALs performed from 2001 to 2006 versus2007-2012 was similar (40.5% vs. 26.6%, respectively, P = 0.07). Most subjects (86.2%) were on ≥1 antimicrobial at the time of BAL. Most (65.8%) negative BALs were associated with narrowing antimicrobial therapy, while most (74.1%) positive BALs were associated with continuing or changing to targeted antimicrobial therapy.In this study population, the diagnostic yield of BAL was similar to that previously described and unchanged in more recent years. Both negative and positive BALs were associated with changes in antimicrobial management.A 10-year retrospective review of bronchoalveolar lavage in 123 immunocompromised children determined that the rate of isolation of potential pathogens was 31% in this population. The majority of BAL was associated with a change in antimicrobial therapy. Pediatr Pulmonol. © 2016 Wiley Periodicals, Inc.
View details for DOI 10.1002/ppul.23644
View details for PubMedID 28052585
Improving case finding of invasive aspergillosis in children using string searches.
American journal of infection control
Surveillance for invasive Aspergillus (IA) in children is complex. We performed a retrospective study (2004-2013) using string searches of relevant terms within histopathology and radiology reports in efforts to improve detection of IA. Overall, 22 children met IA criteria, of whom 5 (23%) were only identified by string searches.
View details for DOI 10.1016/j.ajic.2016.04.230
View details for PubMedID 27375058
Congenital Parvovirus B19 Infection: Persistent Viremia and Red Blood Cell Aplasia.
Open forum infectious diseases
2015; 2 (2): ofv049-?
We describe a case of fetal parvovirus B19 infection resulting in preterm birth and leading to hydrops fetalis requiring multiple in utero transfusions. The infant developed chronic postnatal anemia responsive to intravenous immunoglobulin therapy. Serum viral load decreased after immunoglobulin treatment but remained detectable for over 1 year.
View details for DOI 10.1093/ofid/ofv049
View details for PubMedID 26288800
- Fever, Emesis, Abdominal Pain, and Pancytopenia in a 16-Year-Old Girl PEDIATRIC INFECTIOUS DISEASE JOURNAL 2009; 28 (10): 931-?