Duke doctor leads worldwide effort to treat pediatric fungal infections

Feb. 16, 2014 @ 05:38 PM

William Steinbach had been a doctor only about six weeks when he met an 8-year-old boy with leukemia.

The boy’s mother spoke only Mandarin, so the medical staff had to relay somber information to the boy, who spoke English and could translate for his family, about an invasive fungal infection named aspergillosis that was taking over his body and killing him.

He ended up dying.

That was 1998, the start of Steinbach’s Stanford University pediatrics residency, and at that time, there was no solid research being done on how to prevent, diagnose or treat fungal infections in children who are already combatting a serious illness or adapting to new organs. Many of these infections were seen as untreatable, a death warrant.

“I remember that day thinking, ‘This is how I want to change the world,’” Steinbach said. “‘This is what I want to do.’”

Now, Steinbach is the only pediatric fungal infection specialist at Duke. There are only about a dozen of these niche specialists in the world.

Some mornings, it isn’t uncommon for him to wake up to emails from Europe or Asia, from doctors asking for his help in treating their patients’ infections.

Duke is home to the largest group of invasive-fungi researchers in the world, he said, and this year, he and his team are using a $3-million National Institutes of Health grant to enroll pediatric patients and research therapy methods. They want eventually to create the international guidelines for fungal infection treatment.

Three young Duke patients have been enrolled in the study since January. The goal is to sign up 600 pediatric patients across 38 sites around the world in four years.

Duke is the only participating site in North Carolina, and during the study, researchers will monitor the effectiveness of different treatments used on these patients who have invasive candidiasis, a fungal infection caused by yeasts.

Steinbach submitted another $4-million NIH grant application last fall. The funding would be used to examine diagnostic tools for fungal infections.

He also continues to build up the International Pediatric Fungal Network, which he formed in 2005 to connect researchers from around the world and provide families with more medical information. The network is the first large collaborative effort devoted to children, since a majority of past fungal infection research has been focused on adults.

These young patients have had their immune systems lowered during treatments for other conditions, allowing easy access for such infections. Steinbach describes these fungal infections as first-world, manmade diseases.

“I could remember the name and face of every child that died of fungal infection,” he said of his beginning years as a doctor.

“And now, I just can’t. There are too many.”

To learn more

For more information on the International Pediatric Fungal Network, visit www.ipfn.org.