- Assistant Professor, Medicine
INSTITUTION AND LOCATION
FIELD OF STUDY
Shiraz University School of Medicine, Iran
Resident, Tehran University Hospital, Iran
Graduate school, Gifu University School of Medicine, Gifu, Japan
Post Doctoral fellow, Department of Microbiology & Immunology, Medical College of Ohio,Toledo, Ohio
Microbiology and immunology
Research Associate, Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio
Intern, Family Practice, Bethesda Family
Practice, Cincinnati, Ohio
Resident, Internal Medicine, Department of Internal Medicine, Good Samaritan Hospital, Cincinnati, Ohio
Fellow, Infectious Diseases, Department
of Internal Medicine, Division of Infectious
Diseases, University of South Florida,
- Ph.D. Dermatology
- Gifu University School of Medicine, Gifu, Japan
- Shiraz University School of Medicine, Shiraz, Iran, Islamic Republic of
- Dept. of Medicine/Valley Fever Center for Excellence, University of Arizona (2017 - Ongoing)
- Florida State University, College of Medicne (2014 - 2017)
- Intercoastal Medical Group (2013 - 2017)
- Infectious Disease Associates (2010 - 2013)
- Dept. of Internal medicine, Div. Infectious Disease, University of Cincinnati (2001 - 2004)
- Dept. of Microbiology & Immunology, Medical College of Ohio (1997 - 2001)
- JSID International Scholarship (Kao Award)
- JSID, Summer 1996 (Award Finalist)
- Graduate Scholarship for Graduate Course, Ministry of Education and Science, Japan
- Ministry of Education and Science, Japan (March 93 -March 97), Spring 1993 (Award Finalist)
- Research Fellowship Scholarship, Ministry of Education and Science, Japan (January 1992 - March 1993)
- Ministry of Education and Science, Japan (January 1992 - March 1993), Winter 1992
Licensure & Certification
- Certification examination in Infectious Disease, American Board of Internal Medicine (2010)
- Certification examination in Internal Medicine, American Board of Internal Medicine (2008)
- Arizona State Medical Board, Arizona State Medical Board (2017)
- Florida State Medical Board, Florida State Medical Board (2015)
We are reminded daily of the critical importance of teachers to the benefit and advancement of civilization. Passing on to others the fruits of one's education, research and experience is an absolute requirement and enduring gift to society. I consider research, clinical duties and teaching as the three most important aspects of my life's work.As an Infectious disease physician, one of my main goals is cultivating the interest in various fields of infectious diseases among the fellows, residents and medical students and general public. In particular I enjoy sharing my expertise in medical mycology especially Coccidioidomycosis and other areas of infectious disease such as virology (HIV and hepatitis).The education of the ID fellows is focused on complicated cases (eg. HIV/AIDS, hepatitis, transplant patients and complicated surgical infections) that they will encounter in near future as they complete their training.In a similar vein with medical residents, I seek to encourage them to be aware of the importance of infectious disease in general medical practice and make them comfortable with various infectious diseases that they will confront in daily practice.With medical students, my goal is to open their minds and have them experience the importance of infectious diseases and all aspects of medicine and perhaps encourage some to consider ID as their future carier.With the general public, it is important to educate everyone about how infectious diseases touch their lives. This might include a broad range of activities such as addressing local groups about Valley Fever, or speaking to the media to raise awareness about the overuse of antibiotics and the ongoing challenges with antibiotic resistance. As important as it is to educate others, It is equally important to continue educate myself. This include reviewing other's research, stay abreast of the latest advancements in antimicrobials and attending conferences to further advance my education.
As both a practicing physician and a research scientist I have long cultivated a particular interest in medical mycology. After completing my medical residency in Iran, I attended graduate school at the Gifu University, School of Medicine in Japan and obtained my Ph.D. My research focus was in Candida albicans. I developed specific training and expertise in protein purification, molecular biology and gene manipulation techniques. My research focused on the identification of virulence factors and the interaction of the fungus with the human host.After securing a post- doctoral fellowship position at the Medical College of Ohio, I shifted my research to coccidioides immitis. I identified and purified urease protein and constructed a urease knock out strain of this fungus which demonstrated lesser virulence in an animal model. My research showed promise for the development of a coccidioides immitis vaccine. I moved to the University of Cincinnati where our emphasis was involved with genetic manipulation of Histoplasma capsulatum and the fungal-host interaction in an animal model.In 2004, I was fortunate to be given an opportunity to begin a residency in Internal Medicine and later completed an Infectious Disease fellowship with a focus in tropical medicine. That experience and my years as a practicing infectious diseases physician gave me a unique appreciation and understanding of the attention to detail required of a research scientist and the challenge treating patients with opportunistic fungal infections. Returning to my roots at the Valley Fever Center for Excellence (VFCE) in April of 2017, I initially proposed to evaluate an observation that an earlier diagnosis of coccidioidomycosis (Valley Fever) can reduce unnecessary tests and treatments, reduce costs, and potentially lessen morbidity and mortality. In the interim, I have secured a CDC contract to further evaluate this observation. Our studies have shown a significant financial benefit with decreasing the delay of an initial diagnosis of Valley Fever. Additional benefits would include but not be limited to improving antibiotic stewardship, developing population management programs, and serving as a model to address other opportunistic infections. The study is completed and results are being submitted for publication.Concurrently, I am the PI for FLEET-Valley Fever study, which is a collaborative work under the direction of NIH involving Duke University and the Valley Fever Center for Excellence. Basically FLEET is a clinical trial of the antifungal medication Fluconazole as early empiric treatment of cocidioidomycosis Pneumonia in adults presenting with community acquired pneumonia. In a new CDC funded study, I am investigating a novel rapid Lateral Flow Assay (LFA) technique for rapid diagnosis of coccidioidomycosis to reduce the unnecessary use of antibacterial drugs. An intriguing benefit of this proposal is to address the gap in prompt diagnosis of coccidioidomycosis that results from the turn-around time for current diagnostic tests of at least one and usually three or more days. This prospective study is approved by UA IRB and currently underway for patient enrollment. Another current research interest of mine has been to spark an interest among Hematology and Pulmonology specialists at BUMC to investigate the possible reactivation of Valley Fever in patients with advanced cancers who are being treated with check point inhibitors such as new agent Keytruda.Additionally, I am launching a new investigation in delays in Valley fever diagnosis through Valley Fever center for Excellence. We joined Banner Health through its quality improvement program of the Clinical Consensus Groups (CCG) to define and design an explicit clinical practice program for primary care practitioners of Banner’s Arizona Medical Group, University Medical Group, urgent cares, and hospital emergency departments to diagnose VF more promptly and manage it more precisely. We titled the clinical practice “Identification, Evaluation and Management of Coccidioidomycosis in Adult Outpatients.” My Specific Aims for this project are listed:1) Identify the clinical cues that lead to earlier diagnosis of coccidioidal infections. 2) Assess the impact of clinical practice training on diagnosis and management of Valley fever.
No activities entered.
- Bardwell, J., August, J., Farran, S., Florita, C., Donovan, F., & Zangeneh, T. T. (2019). Infection of Aortic Endograft Caused by Coccidioidomycosis. The American journal of medicine.
- Donovan, F. M., Shubitz, L., Powell, D., Orbach, M., Frelinger, J., & Galgiani, J. N. (2019). Early Events in Coccidioidomycosis. Clinical microbiology reviews, 33(1).More infoSUMMARYSince its description nearly 130 years ago, hundreds of studies have deepened our understanding of coccidioidomycosis, also known as valley fever (VF), and provided useful diagnostic tests and treatments for the disease caused by the dimorphic fungi spp. In general, most of the literature has addressed well-established infections and has described patients who have experienced major complications. In contrast, little attention has been given to the earliest consequences of the pathogen-host interaction and its implications for disease manifestation, progression, and resolution. The purpose of this review is to highlight published studies on early coccidioidomycosis, identify gaps in our knowledge, and suggest new or former research areas that might be or remain fertile ground for insight into the early stages of this invasive fungal disease.
- Donovan, F. M., Wightman, P., Zong, Y., Gabe, L., Majeed, A., Ynosencio, T., Bedrick, E. J., & Galgiani, J. N. (2019). Delays in Coccidioidomycosis Diagnosis and Associated Healthcare Utilization, Tucson, Arizona, USA. Emerging infectious diseases, 25(9), 1745-1747.More infoTucson, Arizona, USA, is a highly coccidioidomycosis-endemic area. We conducted a retrospective review of 815 patients in Tucson over 2.7 years. Of 276 patients with coccidioidomycosis, 246 had a delay in diagnosis; median delay was 23 days. Diagnosis delay was associated with coccidioidomycosis-related costs totaling $589,053 and included extensive antibacterial drug use.
- Donovan, F. M., Zangeneh, T. T., Malo, J., & Galgiani, J. N. (2017). Top Questions in the Diagnosis and Treatment of Coccidioidomycosis. Open forum infectious diseases, 4(4), ofx197.More infoRevised and greatly expanded treatment guidelines for coccidioidomycosis were published last year by the Infectious Diseases Society of America. We have selected 4 questions that commonly arise in the management of patients suspected of this disease and for which there remain divided opinions.
- Donovan, F., Blatt, S., & Gonzales, Y. (2006). Cat Scratch Disease Presenting as Severe Thrombocytopenia. Resident and Staff Physician.
- Mirbod, F., Nakashima, S., Kitajima, Y., Ghannoum, M. A., Cannon, R. D., & Nozawa, Y. (2017). Molecular cloning of a gene encoding translation initiation factor (TIF) from Candida albicans. Journal of medical and veterinary mycology : bi-monthly publication of the International Society for Human and Animal Mycology, 34(6), 393-400.More infoThe differential display technique was applied to compare mRNAs from two clinical isolates of Candida albicans with different virulence; high (potent strain, 16240) and low (weak strain, 18084) extracellular phospholipase activities. Complementary DNA fragments corresponding to several apparently differentially expressed mRNAs were recovered and sequenced. A complementary DNA fragment seen distinctly in the potent phospholipase producing strain was highly homologous to the yeast translation initiation factor (TIF). The selected DNA fragment was then used as a probe to isolate its corresponding complementary DNA clone from a library of C. albicans genomic DNA. The sequence of isolated gene revealed an open reading frame of 1194 nucleotides with the potential to encode a protein of 397 amino acids with a predicted molecular weight of 43 kDa. Over its entire length, the amino acid sequence showed strong homology (78-89%) to Saccharomyces cerevisiae TIF and (63-80%) to mouse eIF-4A proteins. Therefore, our C. albicans gene was identified to be TIF (Ca TIF). Northern blot analysis in the two strains of C. albicans revealed that Ca TIF expression is 1.5-fold higher in the potent phospholipase producing strain. The restriction endonuclease digestion of genomic DNA from this potent strain revealed at least two hybridized bands in Southern blot analysis, suggesting two or more closely related sequences in the C. albicans genome.
- Donovan, F., Somboonbwit, C., Soliman, E., Gotuzzo, E., & Perez, N. (2009). St. Louis Encephalitis. Web Med.
- Donovan, F., Somboonwit, C., Tash, K., & Houston, S. H. (2009). Immunosuppression and infection risk in SOT receipients. Infections in Medicine, 26(2), 41-46.
- Mirbod-Donovan, F., Schaller, R., Hung, C. Y., Xue, J. M., Reichard, U., & Cole, G. T. (2006). Urease produced by Coccidioides posadasii contributes to the virulence of this respiratory pathogen. INFECTION AND IMMUNITY, 74(1), 504-515.
- Mirbod, F., Schaller, R. A., & Cole, G. T. (2002). Purification and characterization of urease isolated from the pathogenic fungus Coccidioides immitis. Medical mycology, 40(1), 35-44.More infoCoccidioides immitis, the causative agent of San Joaquin Valley fever (coccidioidomycosis), produces a urease which has been suggested to contribute to the virulence of this fungal pathogen. Urease catalyzes the hydrolysis of urea and has been proposed to at least partly account for alkalinity of the microenvironment in which C. immitis grows due to the release of ammonia and ammonium ions. The C. immitis urease was purified to homogeneity (1048-fold) from the mycelial cytosol by chromatographic fractionation. The sequence of 12 N-terminal amino-acid residues of the purified, native polypeptide was identical to that predicted by the translated urease gene sequence which has been reported. The isolated enzyme exhibited a specific activity in the presence of urea of 1750 micromol min(-1) mg(-1) protein, has a native molecular mass of 450 kDa, revealed a Km for urea of 4.1 mM, had a pH optimum of 8.0 and is heat stable. Hydroxyurea, acetohydroxamic acid (AHA) and boric acid each inhibited activity of the purified enzyme. Urease activity was enhanced by the presence of 5-10 mM concentrations of Mg2+ or Mn2+, but inhibited by Li+, Ni2+, Cu2+ or Zn2+. The reversible urease inhibitor, AHA, blocked enzyme activity in the crude mycelial cytosolic fraction when added at a concentration of 10 mM. On the other hand, 10 mM AHA added to 4-day-old mycelial cultures only partially decreased the amount of ammonium detected in the culture medium. It is evident, therefore, that C. immitis urease activity does not account for the total amount of ammonia secreted during in vitro growth of the pathogen. Other metabolic sources of ammonia, which may also contribute to the virulence of C. immitis, are under investigation.
- Sugiyama, Y., Nakashima, S., Mirbod, F., Kanoh, H., Kitajima, Y., Ghannoum, M. A., & Nozawa, Y. (1999). Molecular cloning of a second phospholipase B gene, caPLB2 from Candida albicans. MEDICAL MYCOLOGY, 37(1), 61-67.
- Leidich, S. D., Ibrahim, A. S., Fu, Y., Koul, A., Jessup, C., Vitullo, J., Fonzi, W., Mirbod, F., Nakashima, S., Nozawa, Y., & Ghannoum, M. A. (1998). Cloning and disruption of caPLB1, a phospholipase B gene involved in the pathogenicity of Candida albicans. JOURNAL OF BIOLOGICAL CHEMISTRY, 273(40), 26078-26086.
- Mirbod, F., Nakashima, S., Kitajima, Y., Cannon, R. D., & Nozawa, Y. (1997). Molecular cloning of a Rho family, CDC42Ca gene from Candida albicans and its mRNA expression changes during morphogenesis. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY, 35(3), 173-179.
- Donovan, F., Nakashima, S., Mori, S., Kitajima, Y., & Nosawa, Y. (1995). Phospholipid biosynthesis in growing and non -growing conditions in Candida albicans. Jpn. J. Med. Mycol, 36, 53-59.
- IBRAHIM, A. S., MIRBOD, F., FILLER, S. G., BANNO, Y., COLE, G. T., KITAJIMA, Y., EDWARDS, J. E., NOZAWA, Y., & GHANNOUM, M. A. (1995). EVIDENCE IMPLICATING PHOSPHOLIPASE AS A VIRULENCE FACTOR OF CANDIDA-ALBICANS. INFECTION AND IMMUNITY, 63(5), 1993-1998.
- MIRBOD, F., BANNO, Y., GHANNOUM, M. A., IBRAHIM, A. S., NAKASHIMA, S., KITAJIMA, Y., COLE, G. T., & NOZAWA, Y. (1995). PURIFICATION AND CHARACTERIZATION OF LYSOPHOSPHOLIPASE-TRANSACYLASE (H-LPTA) FROM A HIGHLY VIRULENT-STRAIN OF CANDIDA-ALBICANS. BIOCHIMICA ET BIOPHYSICA ACTA-LIPIDS AND LIPID METABOLISM, 1257(2), 181-188.
- Donovan, F., Inoue, I., Seishima, M., Mori, S., & Nozawa, Y. (1994). Lipid synthesis during cell growth of Cryptococcus neoformans. Jpn. J. Med. Mycol., 35, 421-427.
- Donovan, F., Mori, S., & Nozawa, Y. (1993). Methods for Phospholipid Extraction in Candida albicans: an Extraction Method with High Efficacy. J. Med. Vet. Mycol., 31, 405-409.
- Donovan, F. (2018, April). Delays in Diagnosis of Coccidioidomycosis in Tucson, AZ. Cocci Study Group. Flagstaff, Arizona.
- Donovan, F. (2018, April). Valley Fever is under-recognized even in endemic areas. Cocci study Group. Flagstaff, Arizona: Coocidioidomycosis Symposium.
- Donovan, F. (2017, August). Delays in diagnosing coccidioidomycosis within its endemic region.. 7th International Coccidioidomycosis Symposium. Standford, CA: Stanford Center for Continuing Medical Education.
- Donovan, F. (2017, November). Delays in diagnosing coccidioidomycosis within its endemic region.. Jr Investigator Poster Forum. College of Medicine-Tucson, University of Arizona.