{"id":190581,"date":"2022-09-27T10:04:27","date_gmt":"2022-09-27T14:04:27","guid":{"rendered":"https:\/\/today.uconn.edu\/?p=190581"},"modified":"2022-09-27T10:04:27","modified_gmt":"2022-09-27T14:04:27","slug":"physician-returns-with-elite-training-in-challenging-infections","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2022\/09\/physician-returns-with-elite-training-in-challenging-infections\/","title":{"rendered":"Physician Returns With Elite Training in Challenging Infections"},"content":{"rendered":"<p>It\u2019s all around us, hiding in plain sight, and it can make some people very sick without knowing what <em>it<\/em> even is.<\/p>\n<p>But unlike COVID-19, this infectious disease does not have a vaccine and is not highly contagious. And even though the bacteria themselves are ubiquitous, illness from them is relatively uncommon.<\/p>\n<p>Still, non tuberculous mycobacteria infections have been on the rise in recent years as advances in diagnostic testing have improved doctors\u2019 ability to detect them. And once they take hold, they can be severe.<\/p>\n<figure id=\"attachment_190580\" aria-describedby=\"caption-attachment-190580\" style=\"width: 240px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"size-medium wp-image-190580 img-responsive lazyload\" data-src=\"https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-240x300.jpg\" alt=\"Dr. David Fraulino portrait white coat\" width=\"240\" height=\"300\" data-srcset=\"https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-240x300.jpg 240w, https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-819x1024.jpg 819w, https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-768x960.jpg 768w, https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-336x420.jpg 336w, https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1-532x665.jpg 532w, https:\/\/today.uconn.edu\/wp-content\/uploads\/2022\/09\/fraulino-david_UCH_2022-08-04_07-1000x1025-1.jpg 1000w\" data-sizes=\"(max-width: 240px) 100vw, 240px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 240px; --smush-placeholder-aspect-ratio: 240\/300;\" \/><figcaption id=\"caption-attachment-190580\" class=\"wp-caption-text\">Dr. David Fraulino is an infectious diseases physician at UConn Health. (Photo by Tina Encarnacion)<\/figcaption><\/figure>\n<p>\u201cThese infections are pretty complicated,\u201d says <a href=\"https:\/\/health.uconn.edu\/find-a-provider\/physician\/Fraulino-David\">Dr. David Fraulino<\/a>, one of the most recent additions to the UConn Health faculty. \u201cThey cause a spectrum of pulmonary as well as skin and soft-tissue infections, and are pathogens that are notoriously multi-drug resistant, making diagnosis and treatment quite challenging.\u201d<\/p>\n<p>Fraulino is an infectious diseases physician with specialized training in non tuberculous mycobacterial, or NTM, infections.<\/p>\n<p>\u201cNTM are environmental organisms,\u201d Fraulino says. \u201cThey are in soil, dust, and water. They\u2019re all around us. They are often unpredictable in whom they infect or why they infect, but we have some reasons for why certain hosts are more at risk. They are more than capable of causing a devastating disease process in the right host, and it\u2019s very, very difficult to get rid of them. So it can give clinicians a lot of worry and frustration on how to approach it.\u201d<\/p>\n<p>A graduate of UConn\u2019s internal medicine residency program, Fraulino completed an infectious diseases fellowship at the University of Colorado, including elite training in NTM infections at the world-renowned affiliated respiratory hospital National Jewish Health.<\/p>\n<blockquote>\n  <p>I just had such a positive time here as a resident. I felt very supported. <cite> &#8212 Dr. David Fraulino<\/cite><\/p>\n<\/blockquote>\n<p>\u201cWhen I was out in Colorado, we would have people flying from all over the world to come get treated, including many people coming from Connecticut and New England,\u201d Fraulino says. \u201cI would say that was the catalyst of my early thoughts of returning to Connecticut with this training. I knew I wanted to come back here eventually, so maybe I can serve as a more local resource, save patients a flight, and provide the same access to quality care.\u201d<\/p>\n<p>Fraulino grew up in Portland, Connecticut, and went to Salve Regina University in Newport, Rhode Island, for his undergraduate study. He spent time doing immunology research at Harvard Medical School in Boston before attending medical school at the University of New England College of Medicine in Biddeford, Maine.<\/p>\n<p>Before heading out to Denver in the summer of 2020, Fraulino spent the final months of his UConn residency in the throes of the early COVID-19 outbreak, in full personal protective equipment daily caring for patients in the John Dempsey Hospital Intensive Care Unit.<\/p>\n<p>He was convinced when he did return to Connecticut, it would be to join the faculty at UConn Health, which he did July this year.<\/p>\n<p>\u201cI told my family UConn was where I ultimately wanted to be,\u201d Fraulino says. \u201cI just had such a positive time here as a resident. I felt very supported. Residency is an extremely challenging time in any trainee\u2019s life, but if you&#8217;re in an environment that gives you the necessary support to succeed, it really does create an idea and a comfort that makes you want to come back to it.\u201d<\/p>\n<p><a href=\"https:\/\/health.uconn.edu\/find-a-provider\/physician\/Chirch-Lisa\">Dr. Lisa Chirch<\/a>, one of UConn Health\u2019s infectious diseases physicians, worked closely with Fraulino, and he considers her one of his biggest mentors.<\/p>\n<p>\u201cWe are thrilled that he has chosen to come \u2018home\u2019 to UConn,\u201d Chirch say. \u201cWe never wanted him to leave in the first place! His infectious positivity and wit were beloved by many during his residency years, and word of his return spread quickly. We are all so happy to welcome him back.\u201d<\/p>\n<p>Adds <a href=\"https:\/\/facultydirectory.uchc.edu\/profile?profileId=Dieckhaus-Kevin\">Dr. Kevin Dieckhaus<\/a>, division chief, who recruited Fraulino back to UConn Health, \u201cWe are excited that Dr. Fraulino has returned to the University of Connecticut, and are happy to bring in his expertise for management of these difficult-to-treat infections. Dr. Fraulino is available to evaluate any patient who may have a positive microbiologic culture for NTMs to provide guidance on antibiotic therapy.\u201d<\/p>\n<p>Things to watch for that could indicate an NTM infection include pulmonary symptoms such as dry cough, hemoptysis, fatigue, weight loss, or night sweats that have not responded to traditional therapies despite multiple attempts at treatment.<\/p>\n<p>\u201cClassic features of a slowly evolving pulmonary process in a susceptible host with underlying lung disease would be a sign for providers to consider NTM as a potential cause, especially in the setting of someone with conditions such as bronchiectasis or cystic fibrosis,\u201d Fraulino says.<\/p>\n<p>He encourages community physicians to refer suspected cases to UConn Health\u2019s infectious diseases practice.<\/p>\n<p>\u201cOne of the most critical things with NTM infections is not to expose them to too many antibiotics ahead of time, because of how rapidly they become resistant, and to obtain samples for specialized testing,\u201d Fraulino says.<\/p>\n<p><em><a href=\"https:\/\/health.uconn.edu\/infectious-diseases\/\">Learn more about the UConn Health Infectious Diseases Division<\/a>, or call 860-679-2411 for a consultation.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two years after completing an internal medicine residency at UConn Health, Dr. David Fraulino is back, now as a faculty physician, bringing specialized expertise in especially difficult infectious disease.<\/p>\n","protected":false},"author":111,"featured_media":190579,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[2231,1868,179],"tags":[],"magazine-issues":[],"coauthors":[2010],"class_list":["post-190581","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-well-being","category-meds","category-uconn-health"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-13 10:16:05","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/190581","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/111"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=190581"}],"version-history":[{"count":6,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/190581\/revisions"}],"predecessor-version":[{"id":190642,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/190581\/revisions\/190642"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media\/190579"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=190581"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=190581"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=190581"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=190581"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=190581"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}