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Juan Carlos Rico, M.D., and Melinda Standridge, RN review schedules. Image by Evan Lewis

Partners in Care: Prevention is the Key for Keeping Infectious Diseases at Bay

March 14, 2025 | Myeloma patients face several issues, one being compromised immune systems that make them more prone to infection. The UAMS Division of Infectious Diseases plays an important role in ensuring patients are in the best position to continue their cancer treatment.

Under the direction of Michael Saccente, M.D., the Division of Infectious Diseases is part of the UAMS College of Medicine’s Department of Internal Medicine.

“We help with preventing infections and help treat infections when they occur,” said Juan Carlos Rico, M.D., an associate professor who has been with the division since 2014. “We try to come up with guidelines to prevent infections and help patients during their cancer treatments.”

“It takes a lot of time and effort, particularly with myeloma patients,” said Michael Lowry, M.D., an assistant professor who has been with UAMS since 2021 and is a 2014 graduate of the UAMS College of Medicine. “Myeloma is disease that presents unique complications.”

Infectious diseases are illnesses caused by such pathogens as bacteria, fungi, parasites and viruses. Those with underlying medical conditions such as diabetes or heart or kidney disease are more likely to acquire infections. Patients undergoing procedures requiring urinary catheters or other tubes are also more at risk.

For myeloma patients, chemotherapy, immunotherapy and stem cell transplants severely weaken the immune system. To better protect patients from infections, the medical team needs a heightened awareness, including knowing what treatments the patient is undergoing.

“We work with the oncologists to ensure the patient is able to go through treatment,” Rico said. “We also review all of a patient’s past therapies for previous complications or infections.

“It matters if a patient has never had chemotherapy, or if they’re in the hospital after getting a stem cell transplant and they need maintenance chemotherapy. There could be totally different side effects,” Rico continued.

Patients may be unaware of past infections, making the team’s involvement even more important.

“If a patient has had previous infections, it’s possible the infection can come back,” said Rico. “We’ll discuss and recommend a plan for prevention.”

“Any type of minor infection can be life-threatening,” said Lowry. “If there’s any concern at all, they want to get us involved to prevent bad outcomes.”

Lowry noted that sometimes no action is better.

“It’s also important to know when not to treat something,” he said. “It may be a case where the issue will resolve itself or addressing it may interfere with myeloma treatment.”

The Infectious Diseases team intervenes in a variety of situations, Lowry said.

“The most common call we receive is about a patient who has had recent chemotherapy, and they have a fever for some unclear reason,” he said. “Sometimes we get confusing clinical pictures. It’s like detective work — putting the pieces together.”

Communication is a key part of this process.

“A patient may have an abnormal lab or abnormal imaging on a PET scan,” said Rico. “A nurse will send cultures, and if anything is positive, we will be contacted. We follow up with them as an outpatient and remain in contact to ensure the problem doesn’t return.”

“We work closely with the myeloma physicians, nurses, clinic staff, the hospitalists as well as the Infusion Center,” Lowry said. “We want to present a united front with the patient so they don’t feel in the dark about what’s going on.”

Lowry enjoys working with the Myeloma Center.

“A great thing about working with myeloma patients is you may see someone from down the street or someone from across the country. I want to continue our reputation as the best center in the world.”

Rico summarized the goal of his division.

“Prevention is the key. If we can prevent a patient from having infections, it’s the best thing.”