Division Focus: Pediatric Infectious Diseases

UNC Children’s Infectious Diseases program offers expert care and a renewed emphasis on research.

Division Focus: Pediatric Infectious Diseases click to enlarge Dr. Toni Darville and Dr. Thomas Belhorn discuss patient care with residents.

Children tend to pick up germs and infections as an everyday thing, but when the illness poses a threat to life or is a mystery to his or her physician, the experts in the Division of Pediatric Infectious Diseases—are often called in.

Physicians in the infectious diseases division have broad experience in the management of infections in children, including those that are rare and difficult to treat. Some of those include HIV, hepatitis, bone and joint infections, MRSA, mononucleosis, and infections in immunocompromised hosts.

“We get referrals from partner hospitals or physicians when they have a patient with a difficult to manage infection,” states Ravi Jhaveri, MD. “Most of these tend to be bone infections, respiratory infections, or fevers that have lasted more than two weeks.”

Physicians in the division work closely with the state-of the-art UNC Clinical Molecular Microbiology lab to assist in the diagnosis of infections. The physicians are knowledgeable of the most up-to-date treatments for complicated infections in children, and they are active in promoting preventive strategies including vaccines and infection control methods.

Pediatric Infectious Disease and FUO (Fever of Unknown Origin) Program

Children with recurrent, prolonged, or severe infections are seen in the Children’s Infectious Diseases Clinic on the ground floor of the N.C. Children’s Hospital. Children are referred for outpatient evaluation of prolonged or recurrent fever, enlarged lymph nodes, or suspected immune deficiency.

Children with serious illnesses, such as central nervous system infections, bone infections, endocarditis, and a broad spectrum of serious or difficult-to-treat infections are usually seen on an inpatient basis at the hospital.

Pediatric and Adolescent HIV Program

HIV infection continues to be a worldwide problem. Providers in the Pediatric and Adolescent HIV Program care for infants, children and adolescents who have been exposed to HIV or are infected with the virus. Physicians and caregivers work to find the best medical management to ensure the highest quality of life for each child.

To facilitate treatment of all family members infected with HIV, medical care is often provided in a clinic serving both adults and children. Care providers recognize that each patient has unique needs, and treatment plans are designed to enrich the child's nutritional and developmental needs as well as emotional needs.

Education

Dr. Ravi Jhaveri expounds on a point while going on rounds.
Dr. Ravi Jhaveri expounds on a point while going on rounds.
On the educational side, Infectious Diseases faculty work with the pediatric residency program and routinely listen to residents’ reports. They also deliver noon lectures and educate and mentor residents on patient rounds.

“I have a small group of residents who have been helping me with microbiology projects,” says Dr. Jhaveri. “This also gives me a chance to mentor them.”

His colleague, Thomas Belhorn, MD, has been involved in the design of a new curriculum for medical students and is a course leader in immunology. Dr. Belhorn delivers numerous lectures to medical students and residents to enhance their knowledge of infectious disease and the immune response to infection.

Toni Darville, MD, mentors medical students as well as undergraduate students at UNC in her laboratory, giving them an opportunity to learn facets of basic and translational research.

Research

The division has a strong research component, headed by Dr. Darville, who is studying Chlamydia trachomatis, the most common sexually transmitted bacterial pathogen, which causes chronic pelvic pain and infertility in women. Currently, more than 2 million young adults are infected and the annual cost of complications exceeds $2 billion, making chlamydia infection a major public health problem. To address this issue, Dr. Darville heads up the UNC Chlamydia Laboratory, which includes Pediatric faculty with secondary appointments in Microbiology & Immunology. The focus of Dr. Darville’s lab is to increase understanding of genital tract disease due to chlamydia with the ultimate goal to develop a vaccine to prevent chlamydial disease and improve reproductive health of women worldwide.

Dr. Jhaveri leads a research collaboration on hepatitis C virus in pregnant women and children based in Cairo, Egypt, which involves other investigators at UNC, University of Maryland, and Boston University.

Dr. Belhorn works on quality improvement studies in conjunction with physicians at Duke University to optimize care for HIV-infected and exposed children. He also participates in HIV clinical studies.

Other research in the group focuses on viral hepatitis, especially infants with hepatitis B and C, management of fever in young infants, and improved outcomes for children with infectious diseases. Ongoing studies include a determination of how molecular testing affects the decisions of physicians (i.e., which tests are best and have the most influence).

Geneticists in the Pediatric Infectious Disease division are working to identify genetic determinants in women that alter their susceptibility to infectious diseases, and to develop improved methods of prevention and treatment of those diseases.

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