Infectious Diseases and Virology

At Seattle Children’s, your family has a full team behind you, from diagnosis through treatment and follow-up. From our appointment schedulers to our pediatric nurses, our team is specially trained to work with children and their families. Our facilities and equipment also reflect this kid-friendly, family-centered approach. 

Our Infectious Disease clinicians have special training in the treatment of infectious diseases that affect children and adolescents of any age and involve various organs, including conditions that are common and those that are rare. We focus on how to treat infections in the most effective way, while minimizing potential bad side effects of the treatments on your child’s health and development.

Our Virology team specializes in treating children with human immunodeficiency virus (HIV), neonatal herpes simplex virus (HSV) and congenital cytomegalovirus (CMV) (PDF) (pronounced sy-toe-MEG-a-low-vy-rus).

Our team is involved in research that is transforming the diagnosis, treatment and care of infectious diseases. Learn more about our research work through the Infectious Disease Research Program and the Center for Global Infectious Disease Research.

Germs (bacteria) can infect bones or joints. This can cause pain, swelling and redness. Doctors treat bone and joint infections with antibiotic medicines and sometimes with surgery. Infections in the bones and joints can cause long-term pain and disability. With proper treatment, most can be cured before they cause serious problems.

Most children with bone or joint infections first need to be managed in the hospital to ensure the right diagnosis and treatment. Once the infection is under control, your child can usually finish the treatment at home by taking antibiotics by mouth. Your child will need to be seen every week during treatment for a physical exam and blood work to make sure the infection is healing well and that the antibiotics are not causing any problems. We coordinate these visits with Seattle Children’s orthopedic surgeons. Read more (PDF).

Chronic fatigue syndrome (CFS) is an illness characterized by overwhelming tired feelings (fatigue) and weakness that make it difficult to do regular daily activities, like getting out of bed, dressing and eating. While the cause of CFS is not yet known, it has not been shown to be caused by an infection.

The symptoms of CFS can be the same as other illnesses, such as viral infections and hormone problems. The condition can affect school performance and cause physical and emotional symptoms that can last for months or even years. If your child has symptoms consistent with CFS, we can help make sure your child’s symptoms are not caused by a treatable infection.

Studies have shown that remaining as active as possible and keeping a daily schedule provide the best chance for improvement and that most children can eventually return to their regular level of functioning. Certain lifestyle changes can help. This includes regular planned exercise, stress management, a healthy diet and good sleep habits. Read more.

When women are infected with certain germs (viruses, bacteria or parasites) during their pregnancy, their babies may be born with infections that can cause serious health problems. Examples include CMV (PDF) (Spanish), herpes simplex virus (HSV), syphilis (pronounced SIFF-ill-iss), human immunodeficiency virus (HIV) (PDF), Zika virus and toxoplasmosis (pronounced tok-so-plaz-MOE-sis).

We see women during pregnancy before their baby is born to help make a diagnosis and to discuss risks for their baby and options for treatment. We also see infants after birth to make a diagnosis and manage treatment if they are infected.

Many conditions can cause fever, including infections. Fever of unknown origin is a fever that lasts longer than 2 weeks and has no source that doctors can find. Our team’s goal is to determine if an infection is causing your child’s prolonged fever.

We provide care for children with serious (invasive) infections who need antibiotic medicines through a vein by IV or central line while in the hospital. Infections that usually need IV antibiotics include:

• Meningitis (inflammation of the tissues that cover the brain and spinal cord)
• Infections of the bloodstream
• Endocarditis (infection in the heart)
• Brain infections (abscesses)

After your child starts getting better, they can sometimes leave the hospital but will still need IV antibiotics. We will monitor your child after they leave the hospital to make sure the infections continue to improve and that the antibiotics are not causing any bad side effects. We will work with other providers taking care of your child and the home healthcare company providing the IV antibiotics. Read more (PDF).

The human immunodeficiency virus (HIV) causes the disease acquired immunodeficiency syndrome (AIDS). HIV infects and damages a type of white blood cell in the immune system called T helper cells (T cells). A weakened immune system makes children less able to fight off germs and disease. Pregnant women who are infected with the virus can expose their unborn babies.

Teens and young adults may be at risk for getting HIV through unprotected sex with a person who has HIV or by sharing IV drug needles with a person with HIV. Our pediatric HIV providers have many years of experience treating children and adolescents infected with HIV using the most up-to-date treatments.

Children infected with HIV need to be seen every 3 to 4 months to monitor their medicines. We will coordinate visits and blood tests with your child’s primary care provider if you cannot make frequent clinic visits. Read more about HIV (PDF). Also, visit our Patient and Family Resources page for more HIV-related resources.

Lyme disease is an infection caused by germs (bacteria) called Borrelia burgdorferi and Borrelia mayonii. Your child may get Lyme disease after being bitten by a tick that carries the bacteria. The tick must be attached for 36 hours or more to transmit the germs to a person. Typical early symptoms include a target-shaped (bull’s eye) rash, fever, headache, and muscle or joint pain. Very few cases of Lyme disease occur in the state of Washington because most ticks do not carry the specific germs that cause the disease. Most cases of Lyme disease in the state occur after a person returns from travel to areas of the country where Lyme disease is more common.

Lyme disease can be successfully treated with antibiotic medicine. In rare cases, children may continue to have symptoms even after successful treatment. These symptoms usually improve over time. Studies have shown that longer treatment with antibiotics does not make these symptoms go away faster. Read more about Lyme disease (PDF) or learn about the 2-step test to diagnose Lyme disease through the Centers for Disease Control and Prevention (CDC).

Lymph nodes are groups of cells that are part of the immune system. They trap and process germs that get into our bodies. Children get swollen lymph nodes (lymphadenopathy) for a variety of reasons. They are usually a normal reaction to a routine infection and do not require treatment.

Lymph nodes that stay large for a long period of time can be due to a chronic infection. Sometimes the lymph nodes get infected, called lymphadenitis or adenitis. Lymphadenitis is often treated with antibiotic medicines. Non-tuberculous mycobacteria or NTM (also referred to as atypical mycobacteria) is a type of bacteria that can cause lymphadenitis. Read more about NTM lymphadenitis (PDF).

MRSA (pronounced MER-suh) stands for methicillin-resistant Staphylococcus aureus (Staph). Methicillin is a type of antibiotic medicines used to treat infections caused by Staph, a germ (bacteria) usually found on a person’s skin and mucous membranes (nostrils and mouth). MRSA is not killed by common antibiotic medicines, including methicillin. Healthcare providers must use different antibiotics to treat infections caused by MRSA.

MRSA is often the cause of repeated (recurrent) skin infections. We work with children and young adults who have been diagnosed with repeated MRSA infections to help prevent the recurrence of infections. Read more (PDF).

Repeated (recurrent) fevers are above 101 degrees Fahrenheit (38.3 degrees Celsius) and last at least 3 days. They come back every 3 to 6 weeks for at least 6 months. Germs like bacteria, viruses and parasites may be the cause of recurrent fevers. Some genetic diseases also cause recurrent fevers. If your child is referred for recurrent fevers, please bring details about the fevers (how often they occur, how high they are and how long they last) and information on your child’s symptoms when they have a fever. Read more (PDF).

Tuberculosis (TB) is a highly contagious disease caused by germs (bacteria) that often attack the lungs. The bacteria can also damage other parts of the body. TB spreads through the air when a person infected with the disease talks, sneezes or coughs. TB infections can be active or inactive. We work with Public Health – Seattle and King County to care for children exposed to or infected with TB. Read more (PDF).

If your child comes to our clinic with a concern for TB, we may ask you to wear a mask until we determine if other caregivers in the home also have the disease. We may need to get chest X-rays of family members to check for TB. Your child’s doctors and nurses may also need to wear masks in the room until your child begins treatment.

If your child is diagnosed with TB, we will give them antibiotic medicines and see them in our clinic regularly to make sure the antibiotics are working. If your child has an inactive infection (one that isn’t causing symptoms yet), we will give treatment recommendations to their primary care provider.

Our team’s goal is to determine if an infection is causing your child’s symptoms. We do this by reviewing records from your child’s doctors and asking many questions about your child’s travel history, exposure to animals, past illnesses and diseases that run in the family. We will also perform a physical exam.

After performing a physical exam and gathering your child’s medical history, we may recommend additional tests. Depending on your child’s symptoms, this may include:

• Blood tests
• Imaging studies, such as a chest X-ray
• Cultures – body tissue or fluids that are evaluated in the laboratory to detect and identify infections

We will likely provide a diagnosis and treatment recommendations based on what we learn at the visit and through test results.

Depending on your child’s diagnosis, we may recommend several treatments, including oral or intravenous (IV) antibiotics.

We may need to see your child for follow-up visits depending on their diagnosis and treatment plan. We will coordinate these visits as much as possible with your child’s other medical appointments. We may order blood work to make sure the infection is healing well.

We may recommend that you see another specialist depending on the results of your child’s evaluations and tests. 

We provide travel health consultation for children traveling outside of North America. Referrals for travel health advice should be made 7-8 weeks prior to a scheduled trip. We also provide diagnostic assessments and treatment for children with concerns for post-travel illnesses.