Infectious Diseases

The Department of Infectious Diseases of Qilu Hospital of Shandong University is a backbone clinical department of a National Regional Medical Center, with three major areas of specialization: diagnosis and treatment of bacterial and fungal infections, natural-focal (emerging and sudden-onset) diseases, and fever of unknown origin. Its distinctive features in bacterial and fungal infections include precision diagnosis and treatment of multidrug-resistant organisms, management of difficult and complex infections, multidisciplinary management of invasive fungal disease, medical management of infective endocarditis, and precision diagnosis and treatment of infections caused by atypical pathogens. As a designated department for admitting patients with natural-focal diseases, it undertakes referrals and consultations for related diseases within its jurisdiction. Its clinical specialties include recognition of newly emerging "X" pathogens, comprehensive management of viral infections such as severe fever with thrombocytopenia syndrome, the most comprehensive brucellosis diagnosis and treatment system in China, and rapid diagnosis and targeted treatment of vector-borne diseases, especially rickettsial diseases. The professional specialties in the fever of unknown origin direction include recognition of and intervention for fever and inflammatory cytokine storms, as well as diagnosis and treatment of difficult fever-of-unknown-origin cases. It attaches great importance to integrating medical care and disease prevention, strengthens cooperation with the Center for Disease Control and Prevention, jointly established the Qilu Medical-Prevention Integration Laboratory, and won first place in the medical-prevention integration competitions of Shandong Province and Jinan City. It promotes the coordinated development of medical care, education, and research; in recent years, it has undertaken more than 10 projects, including projects under the National Key Research and Development Program and projects funded by the Natural Science Foundation of Shandong Province, with cumulative research funding exceeding 200 ten-thousand yuan.

At present, our department has 1 doctoral supervisor in infectious diseases and 2 master's supervisors. Professor Ma Lixian is a renowned Chinese expert in infectious diseases and was the first doctoral supervisor specializing in infectious diseases in Shandong Province. His research on epidemic hemorrhagic fever holds an important position in China, and his research findings have been included in nationally compiled medical textbooks. Professor Xing Quantai has profound expertise in fever of unknown origin, and many patients from within and outside the province come to seek his care because of his reputation. Professor Wang Gang specializes in the diagnosis and treatment of bacterial and fungal infections, infections caused by emerging pathogens, novel coronavirus, EB virus, and other viral infections, and was the first in China to identify infections caused by two atypical pathogens. Professor Sai Lintao’s main clinical areas are invasive fungal disease, difficult and complex infectious diseases, natural-focal diseases, and others.

The Department of Infectious Diseases includes expert outpatient services, disease-specific outpatient services, a fever clinic, and an intestinal disease clinic. It currently has 41 medical staff and includes a bacterial and fungal infection ward, a natural-focal disease ward, a fever of unknown origin ward, an isolation ward, and an isolation monitoring ward. It is equipped with advanced medical equipment, including a bedside bacterial culture satellite station, ventilators, bedside hemofiltration machines, high-flow oxygen therapy devices, bedside electronic bronchoscopes, and medical intelligent robots, enabling it to independently provide treatment for critical infectious diseases.

Introduction to Key Specialty Directions

Bacterial and fungal infections: ① Diagnosis and treatment of multidrug-resistant organisms: With the widespread use of antimicrobial drugs, the detection rate of multidrug-resistant organisms has increased year by year worldwide, and the situation regarding severe infections caused by multidrug-resistant organisms is not optimistic. The Department of Infectious Diseases has extensive clinical experience in the early recognition of severe infections, interpretation of test results for multidrug-resistant microorganisms, and precision antibiotic treatment. In previous clinical work, large numbers of patients with infections caused by "extended-spectrum β-lactamase (ESBLs)-producing organisms, methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter baumannii (CR-AB), vancomycin-resistant enterococci (VRE), multidrug-resistant Pseudomonas aeruginosa (MDR-PA), and Clostridioides difficile (CD)" received precision treatment, saving their lives. ② Multidisciplinary management of invasive fungal disease: As clinical diagnosis and treatment protocols have become increasingly complex, the incidence of invasive fungal disease (invasive fungal disease, IFD) has increased year by year with the widespread use of various invasive procedures, broad-spectrum antibiotics, immunosuppressants, glucocorticoids, and cancer chemotherapy drugs. The prevalence and case-fatality rate of invasive fungal disease continue to rise, seriously threatening patients’ health. Common pathogenic fungi include Candida, Aspergillus, Cryptococcus, and Mucor. Invasive fungal disease has an insidious onset and atypical clinical symptoms, making early diagnosis difficult. Our department identifies fungal infections through standardized microbiological examinations (direct fungal microscopy, fungal culture and identification, fungal serological examinations, and molecular biological methods) and histopathological examinations, providing valuable experience for clinical practice. In recent years, rare infection cases involving Rickettsia conorii, Trypanosoma, Burkholderia pseudomallei, Talaromyces marneffei, and others have been diagnosed. ③ Medical management of infective endocarditis: With the development of cardiac surgery and population aging, the incidence of infective endocarditis has shown an increasing trend. Blood culture-negative infective endocarditis in particular is a major clinical challenge; delayed diagnosis and difficulty in determining appropriate treatment may lead to high morbidity and mortality. According to reports in the international literature, the pathogens of blood culture-negative infective endocarditis, listed in descending order of frequency, are: Coxiella burnetii, Bartonella, Tropheryma whipplei, fungi, Legionella pneumophila, Mycobacterium tuberculosis, and others. Through standardized diagnostic and treatment procedures, combined with second-generation sequencing, PCR, and serological testing technologies, our department has detected multiple cases of Bartonella-associated endocarditis and Coxiella burnetii endocarditis, and has accumulated extensive clinical experience in infective endocarditis, especially blood culture-negative endocarditis. ④ Diagnosis and treatment of infections caused by atypical pathogens: In 2017, the Department of Infectious Diseases of Qilu Hospital was the first in Shandong Province to apply microbial metagenomic next-generation sequencing technology to the clinical diagnosis of infections. Through second-generation sequencing, serological testing, and other methods, it has extensive experience in the diagnosis and treatment of atypical pathogens such as Rickettsia, Legionella, and Mycobacterium tuberculosis. In 2018, mNGS was used to diagnose malignant malaria infection, making it the world’s first case of clinical malaria diagnosis through sequencing. In 2021, human infection with Rickettsia conorii was identified in China for the first time; the relevant findings were published in the internationally renowned infectious diseases journal Emerging Infectious Diseases. In 2022-7, Professor Wang Gang’s research on "the use of second-generation sequencing technology for etiological diagnosis of rickettsial diseases" was presented as a poster at the 31st Annual Meeting of the American Society for Rickettsiology (ASR).

Natural-focal diseases: ① Brucellosis: As the incidence of brucellosis continues to rise, controversies regarding the diagnosis of brucellosis have become an urgent clinical problem requiring resolution. The Department of Infectious Diseases has overcome numerous difficulties and has now established a comprehensive brucellosis diagnosis and treatment system, successfully diagnosing and treating large numbers of patients with complex and severe brucellosis, and sharing its experience in infectious disease journals in China and abroad. ② Severe fever with thrombocytopenia syndrome: In recent years, cases of severe fever with thrombocytopenia syndrome have tended to become more critical. The department has leveraged its professional strengths and developed innovative concepts and methods for treating critically ill patients with severe fever with thrombocytopenia syndrome, successfully saving the lives of many critically ill patients. ③ Infections caused by newly emerging "X" pathogens: Over the past 30 years, more than 40 emerging diseases have appeared, 80% of which are zoonoses originating from animals, mainly vertebrates. Emerging pathogens, including the novel coronavirus, seriously threaten public health security. The Department of Infectious Diseases works with research institutes and centers for disease control and prevention to build a full-chain recognition and identification system, becoming an important center in China for the diagnosis and treatment of emerging and sudden-onset infections; ④ Hemorrhagic fever with renal syndrome is a classic disease of the Department of Infectious Diseases. The combination of traditional experience and blood purification technology has created a diagnosis and treatment model with distinctive specialty features, which has been incorporated into national guidelines.

Fever of unknown origin: Fever of unknown origin (fever of unknown origin, FUO), also called fever of undetermined cause, is one of the common difficult-to-diagnose conditions in internal medicine. Because its possible causes involve multiple systems and specialties, clinical diagnosis is difficult. Our department has extensive experience in diagnosing and treating fever of unknown origin. In 2021 alone, nearly 300 patients with fever of unknown origin were admitted to the ward, and a distinctive Qilu Infection diagnosis and treatment process was gradually established. Relying on our department’s existing standardized diagnostic and treatment process and new laboratory technologies such as transcriptomics, we can rapidly and accurately distinguish infectious from noninfectious diseases among cases of fever of unknown origin and provide precise, targeted anti-infective treatment. In addition to etiological and differential diagnosis, the distinctive Qilu Infection diagnostic and treatment process and laboratory indicators can enable early identification of life-threatening and poor-prognosis risks, such as hemophagocytic syndrome and cytokine storm, among patients with fever of unknown origin, allowing timely intervention and improving unfavorable outcomes.

Introduction to Disease-Specific Outpatient Services

EB virus disease-specific outpatient service: EB virus (Epstein-Barr virus) belongs to the human herpesvirus family, and the infection rate in the population is greater than 95%. It is usually an asymptomatic latent infection, but when immunity declines, during disease-related stress, or in the presence of a specific genetic background and other factors, EB virus can cause a variety of diseases, including inflammatory diseases such as prolonged fever and neoplastic diseases such as lymphoma, involving multiple systems and specialties, including infectious diseases, gastroenterology, rheumatology, hematology, oncology, and neurology. At present, there is no unified and clearly defined standard for the diagnosis and treatment of EB virus-related diseases, and clinical management is relatively vague and disorganized. The EB virus disease-specific outpatient service of Qilu Hospital of Shandong University will leverage the multidisciplinary strengths of a general hospital, establish precise EB virus diagnostic methods, help with the early diagnosis of EBV-related tumors, and explore targeted treatment for chronic EB virus infection.

Brucellosis (Brucella disease) disease-specific outpatient clinic: Brucellosis, commonly known as "Brucella disease," is caused by infection with Brucella species and is the most common zoonosis in the world. More than 50 ten-thousand newly diagnosed human brucellosis cases are reported worldwide each year. However, because many cases lack typical symptoms and diagnosis is insufficient, the actual number of people infected with Brucella may be seriously underestimated. Since the mid-90s, brucellosis has become one of the infectious diseases with the fastest-rising reported incidence in China. At present, clinical misdiagnosis and missed diagnosis of brucellosis are common, and there are problems involving nonstandard treatment and difficulty diagnosing complications. In recent years, the Department of Infectious Diseases of Qilu Hospital of Shandong University has established a complete research follow-up cohort for brucellosis and achieved a series of results in brucellosis research, including a systematic evaluation of the advantages and disadvantages of common serological diagnostic methods in the Chinese population, biomarkers for diagnosing brucellosis complications, and neurobrucellosis with intracranial hemorrhage as its first manifestation. The relevant findings were published in the internationally authoritative microbiology journal Journal of Clinical Microbiology (J Clin Microbiol. 2020 Sep 22), as well as in the Nature Publishing Group journal BMC Infectious Diseases. At present, we are conducting several brucellosis-related research projects with CDC, Spain’s Vircell, and other institutions, and have multiple diagnostic methods, including culture, quantitative antibody testing, BrucellaCapt, and molecular testing. The physicians responsible for the disease-specific outpatient service all have extensive experience in diagnosing and treating brucellosis and can provide comprehensive follow-up.

Through the joint efforts of all the medical and nursing staff of the Department of Infectious Diseases, the department received the "Advanced Collective in Fighting the Novel Coronavirus Pneumonia Epidemic of Shandong Province" award in 2020; in 2021, it was awarded the "Model Post for Female Employees to Make Contributions" by the Shandong Provincial Federation of Trade Unions; in 2022, it was selected as the "Chairing Unit of the Shandong Province Specialty Alliance for the Diagnosis and Treatment of Infectious and Febrile Diseases"; it was also the "Deputy Chairing Unit of the Shandong Province Medical Consortium for Infectious Diseases"; and in 2023, it was awarded the "National May 1st Women’s Post" by the All-China Federation of Trade Unions.

Online Appointment Registration and the Department’s Location within the Hospital

At present, our hospital’s online appointment registration supports four methods: WeChat appointment registration, Alipay appointment registration, official website appointment registration, and telephone appointment registration. We recommend that you use WeChat to make an appointment: patients can use WeChat appointment registration - search for and follow the official WeChat account of Qilu Hospital of Shandong University - Patient Services - Appointment Registration - Expert Outpatient Clinic - search for the Infectious Fever Clinic, or search under Disease-Specific Outpatient Clinics for the Brucellosis Disease-Specific Outpatient Clinic and EB Virus Disease-Specific Outpatient Clinic; they can also click here to make an appointment and receive care through the other three methods. At the same time, our department has established a nursing clinic to meet patients’ stoma/wound care needs: search for and follow the official WeChat account of Qilu Hospital of Shandong University - Internet Hospital - Nursing Clinic - Stoma/Wound Care Clinic.

To comply with national standards for the construction and configuration of departments of infectious diseases and fever clinics, renovation of the new site of the Department of Infectious Diseases has been completed, and the department officially moved and began operating there on 2021-1-18. The new address is on the first floor of the Health Building. The specific location within the hospital is as follows: 1,The expert outpatient clinic and disease-specific outpatient clinic of the Department of Infectious Diseases are both located between the Central 1 and South 1 areas of the Health Building; follow the route signs for the fever clinic (located to the west of the fever clinic); 2,The entrance to the fever clinic (including the isolation observation ward) is located between the Health Building and the Comprehensive Building (there is a prominent sign in front of the Health Building); 3,The inpatient wards of the Department of Infectious Diseases are located in the North 1 ward on the first floor of the Health Building, and the entrance is through the south gate of the Health Building. The specific route within the hospital can be found in the image below.

Department consultation telephone: 0531-82166848

You are welcome to search for and follow our department’s official WeChat account (Qilu Infection) to learn more about infectious diseases.