Pediatrician good for immunocompromised kid

[Anonymous]

Hi all, I’ve got an immunocompromised DC who needs a ped with some semblance of understanding what this means. Ie, when he gets a virus he will need antibiotics sooner than later due to his tendency to pneumonia etc. We have a great immunologist who has helped immensely but they are not primary care and don’t have weekend hours. Does anyone have a ped who is familiar enough with this to understand care of immunocompromised is different re infection risk/severity? We are in VA.

[Anonymous]

OP I think that practices affiliated with teaching hospitals sometimes have the breadth and depth of experience to handle what you're describing. The down side might be reduced weekend hours. Our experience is through Georgetown Hospital and our practice is pretty good about cross-specialization input. You could look into options through Fairfax Inova.

[Anonymous]

Thanks!

[Anonymous]

My immuno-compromised child with lupus has always been taken seriously anywhere she goes.

But I have to note that a virus is not treated with antibiotics. Antibiotics come into the picture if there's evidence of bacterial infection. So all that's needed for viral infections is vigilance.

[Anonymous]

Anonymous wrote:My immuno-compromised child with lupus has always been taken seriously anywhere she goes.

But I have to note that a virus is not treated with antibiotics. Antibiotics come into the picture if there's evidence of bacterial infection. So all that's needed for viral infections is vigilance.

agree with this PP immensely (also parent of child taking drugs that makes them immunocompromised due to chronic illness)

And I would hope that all peds take it seriously. But a good ped would never prescribe antibiotics for a virus. A good pediatrician, however, would closely monitor your DC for complications.

Good luck to you.

[Anonymous]

Advanced pediatrics in Vienna still has (last I checked) parking lot visits for sick kids to keep illnesses out of the office. They also have a sick entrance and a well entrance. I’ve had an immunocompromised kid myself and I know what it comes with, but I’ve never asked for abx preemptively before - I am terrified of overuse of abx. That said, I think they would work with you.

[Anonymous]

OP here. Yes, I know about viruses and bacteria. I have medical training myself but don’t want to treat my own child. My child frequently gets bacterial infections following viral due to their primary immunodeficiency. We need someone on the primary end who is familiar enough with this to understand our treatment options long term ( which are ironically chronic antibiotics which I don’t want to do, or IVIG which DC doesn’t want). Thanks to the first poster. We have a new ped appt at Georgetown university.

[Anonymous]

Anonymous wrote:Hi all, I’ve got an immunocompromised DC who needs a ped with some semblance of understanding what this means. Ie, when he gets a virus he will need antibiotics sooner than later due to his tendency to pneumonia etc. We have a great immunologist who has helped immensely but they are not primary care and don’t have weekend hours. Does anyone have a ped who is familiar enough with this to understand care of immunocompromised is different re infection risk/severity? We are in VA.

Get the immunologist to write a note that says the child is immunocompromised, has a hx of severe illness and requires earlier, more aggressive treatment. Get a copy of this, get it put in ped's file and keep a copy too.

This is better than one doctor who gets it because even with one doc that gets it, you will often need to see a different doc in the practice for an urgent sick visit or a different doc is on call. or you end up at urgent care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My immuno-compromised child with lupus has always been taken seriously anywhere she goes.

But I have to note that a virus is not treated with antibiotics. Antibiotics come into the picture if there's evidence of bacterial infection. So all that's needed for viral infections is vigilance.

agree with this PP immensely (also parent of child taking drugs that makes them immunocompromised due to chronic illness)

And I would hope that all peds take it seriously. But a good ped would never prescribe antibiotics for a virus. A good pediatrician, however, would closely monitor your DC for complications.

Good luck to you.

The point is that viruses lead to bacterial infections and immunocompromised people need earlier and more aggressive treatment.

[Anonymous]

Someone double board certified in peds and infectious disease? Or family med and infectious disease?
Call infectious disease dept and ask if they have any.

[Anonymous]

Anonymous wrote:OP here. Yes, I know about viruses and bacteria. I have medical training myself but don’t want to treat my own child. My child frequently gets bacterial infections following viral due to their primary immunodeficiency. We need someone on the primary end who is familiar enough with this to understand our treatment options long term ( which are ironically chronic antibiotics which I don’t want to do, or IVIG which DC doesn’t want). Thanks to the first poster. We have a new ped appt at Georgetown university.

The ped is for management of acute illnesses. They are not going to be familiar with longterm tx of immune deficiency. The options you raise are handled by the immunologist.

There is an at home option for sub q infusion of IVIG. Not sure if that's more palatable for your DC.