About

Cristin R Gengler is a certified pediatric nurse practitioner and certified primary care mental health specialist practicing at Stony Brook University Hospital and affiliated locations. She graduated from Stony Brook School of Nursing in 2007 and earned her master's of science degree in 2011. With extensive experience in general pediatrics, she focuses on understanding the entire child to better address their behaviors and health needs. Her areas of interest include mental health, ADHD, anxiety, adolescence, and medication management. Cristin collaborates closely with the division of developmental pediatrics to support families and patients from a young age through adolescence. She holds the academic title of Clinical Instructor in Pediatrics at Stony Brook and is actively involved in patient care at Stony Brook Advanced Pediatric Care.

Selected publications

• A Prospective Cohort Longitudinal Study of Human Acute Babesiosis: Quality of Life and Severity of Symptoms Through 1-Year Follow-up

  Open Forum Infectious Diseases · 2025-10-29

  articleOpen access

  Abstract Background Babesiosis, caused by the parasitic blood-borne piroplasm Babesia microti, is emerging in the Northern hemisphere. We aimed to study long-term symptoms of patients with B microti infection in New York. Methods A prospective longitudinal cohort study of human babesiosis was conducted at Stony Brook University Hospital. Inclusion criteria were age ≥18 years with positive blood smear for Babesia spp. Symptoms were assessed in patients at presentation and at 1, 6, and 12 months by 3 validated surveys: a visual analog scale, a quality of life (QOL) questionnaire, and the 36-Item Short Form Survey (SF-36). Results In total, 38 patients with acute B microti infection (26% female; age range, 54–73 years) were enrolled from 2020 to 2022. Compared with baseline, the visual analog scale total symptom scores (with high scores representing worse status) significantly decreased at 6-month follow-up for the immunocompetent (n = 9; P < .001) and immunocompromised groups (n = 6; P < .001). Scores remained significantly higher in the immunocompromised group (ratio, 2.6; P = .045). At 1-year follow-up, the scores in the 2 groups tended to be similar (ratio, 0.9; P = .82). Within QOL concept scores (with low scores representing worse status), physical functioning significantly increased after 6 months of follow-up in both cohorts (immunocompetent, n = 10 [P = .004]; immunocompromised, n = 5 [P = .008]) but was still significantly lower in the immunocompromised group at that time (ratio, 0.7; P < .001). By the 12-month follow-up, physical functioning scores in the 2 groups appeared to converge, though the difference remained borderline significant (ratio, 0.9; P = .06). Conclusions The time to convalescence was similar among patients with babesiosis, though immunocompromised patients tended to have more prolonged symptoms and worsened QOL after babesiosis at 1-year follow-up, compared with immunocompetent patients.

  PublisherDOI

• Reduced Cholesterol Levels during Acute Human Babesiosis

  Pathogens · 2023-04-18

  articleOpen access

  Background: Babesiosis, an intra-erythrocytic protozoan disease, is an emerging zoonotic parasitic disease worldwide. Cholesterol levels are correlated with severe infections, such as sepsis and COVID-19, and anecdotal reports suggest that high-density lipoprotein (HDL) cholesterol declines during acute babesiosis. Our aim was to describe the cholesterol levels in patients with acute babesiosis diagnosed in an endemic area in New York, hypothesizing that HDL levels correlate with the severity of infection. Methods: We reviewed the medical records of adult patients with babesiosis diagnosed by identification of Babesia parasites on a thin blood smear and confirmed by polymerase chain reaction from 2013 to 2018, who also had available a lipid profile drawn at the time of clinical presentation. Additional lipid profile levels were considered as “baseline” if they were drawn within 2 months before or after the infection as part of routine care. Results: A total of 39 patients with babesiosis had a lipid profile drawn on presentation. The patients were divided into two groups for comparison based on the treating physician’s clinical decision: 33 patients who were admitted to the hospital and 8 patients who were evaluated as outpatients. A history of hypertension was more common in admitted patients (37% vs. 17%, p = 0.02). The median levels of low-density lipoprotein (LDL) and HDL were significantly reduced in admitted patients compared to non-admitted patients (46 vs. 76 mg/dL, p = 0.04; and 9 vs. 28.5 mg/dL, p = 0.03, respectively). In addition, LDL and HDL levels returned to baseline values following resolution of acute babesiosis. Conclusion: LDL and HDL levels are significantly reduced during acute babesiosis, suggesting that cholesterol depletion may predict disease severity. Pathogen and host factors may contribute to a reduction in serum cholesterol levels during acute babesiosis.

  PublisherOA PDFDOI

• Neurologic Manifestations of Tick-Borne Diseases Transmitted by Deer Ticks (Ixodes scapularis) in the USA

  Current Tropical Medicine Reports · 2023-11-17 · 2 citations

  articleOpen access1st authorCorresponding

  Abstract Purpose of Review This article aims to review the relevant updates in pathogenesis, diagnostics, clinical manifestations, and treatments of tick-borne diseases involving the nervous system, with special emphasis on emerging viral and bacterial infections transmitted by deer ticks ( Ixodes scapularis ). Recent Findings Neuroborreliosis includes a wide array of peripheral and/or central nervous system syndromes, of which diagnosis depends on a combination of clinical gestalt, serum serologic testing, and CSF cellular and serologic analysis. Powassan virus may cause life-threatening neuroinvasive disease and diagnosis that is based on CSF serology with treatment being largely supportive. Neurologic manifestations of anaplasmosis and babesiosis are rare but have been documented in case reports. Diagnosis is dependent on serum molecular and microscopic and serologic testing, and the pathophysiologic mechanisms of these neurologic syndromes are not fully understood. Borrelia miyamotoi is an emerging pathogen and, in immunocompromised patients, can cause severe meningoencephalitis. Summary Ixodes scapularis -borne infections such as Lyme disease, anaplasmosis, babesiosis, Powassan virus, and Borrelia miyamotoi disease can have significant neurologic manifestations. Due to the potential for poor outcomes, physicians must have a working knowledge of these pathogens, and a high index of suspicion is required to screen for these diseases in patients with the correct risk factors. Future research will help realize the full range of neurologic manifestations of these pathogens and also clarify their underlying pathophysiologic mechanisms, which will aid in developing new methods of diagnosis and treatment.

  PublisherOA PDFDOI

• Procalcitonin as a Potential Biomarker in the Study of Babesiosis Caused by B. microti

  Pathogens · 2022-10-23 · 4 citations

  articleOpen access1st authorCorresponding

  Procalcitonin is gaining momentum in the study of protozoal sepsis, but its utility as a biomarker has yet to be fully discovered in human babesiosis. A total of 33 cases of acute babesiosis dating between 2012 and 2019 were retrospectively collected from Stony Brook University Hospital (SBUH) and Stony Brook South Hampton Hospital (SHH), both of which are located on Long Island, NY. Cases were cross-referenced for the need for ICU admission, and the procalcitonin levels were measured by the use of BRAHMS Elecsys assay at SBUH and BRAHMS Architect assay at SHH. Our study demonstrated that the log-transformed procalcitonin levels had a linear correlation with log-transformed maximum parasitemia, which suggests that procalcitonin directly correlates with parasitemia values. Furthermore, when comparing values that predict ICU admission, our ROC analysis of procalcitonin demonstrated similar AUC values to the percentage of parasitemia, suggesting that procalcitonin may assist in determining the severity of disease. We demonstrate that procalcitonin may directly correlate with the parasitemia percentage and have prognostic capabilities, which suggests that procalcitonin may have biomarker potential in human babesiosis.

  PublisherOA PDFDOI

• Feeding Intolerance in a Patient with Advanced Parkinson’s Disease and Vascular Dementia: Lessons Learnt

  The Singapore Family Physician · 2019-07-01

  article1st authorCorresponding
  PublisherDOI

Labs

• Stony Brook Pediatric CarePI