An ongoing dialogue on HIV/AIDS, infectious diseases,
January 14th, 2026
Influenza — So Familiar, Still So Mysterious
In what feels like the fastest-peaking influenza season in quite some time, I find myself returning to a familiar answer when asked questions about this miserable virus: “We just don’t know.” At least I hope it’s peaking — take a look at this encouraging recent trend: Decline notwithstanding, there’s still tons of influenza activity out […]
January 6th, 2026
How the Z-Pak Took Over Outpatient Medicine, Part 2: The Reckoning
Part 1 of this azithromycin series explained how the drug became ubiquitous. In Part 2, we’ll explore why many of us infectious diseases physicians now groan when they hear the words, “They already started a Z-Pak.” Because what began as a genuine pharmacologic advance became, through sheer volume of use, an antibiotic that doesn’t work […]
December 29th, 2025
How the Z-Pak Took Over Outpatient Medicine
Chances are, across this great land of ours, right at this very moment, someone is coughing, or sneezing, or struggling with a sore throat, or some combination of the above, and taking the antibiotic azithromycin. Or they might be just fevering, with no discernible cause, and still they’re taking azithromycin. They might have obtained it […]
December 17th, 2025
What Use Is the Physical Examination in Current Medical Practice?
A very interesting, quite scholarly perspective appeared in the NEJM last month called, “Strategies to Reinvigorate the Bedside Clinical Encounter.” Drawing plenty of attention on social media, it elicited the usual hand-wringing from clinicians who bemoaned the way modern medicine has evolved — away from direct care of patients and toward an ever-expanding reliance on […]
December 10th, 2025
Dengue, Malaria, HIV Cure, and Others — First Cold Snap of the Winter ID Link-o-Rama
Absolutely brutal temperatures arrived up here in Boston over the past week, just in time for the peak holiday season, and we’ve even had a dusting of snow. Here’s proof, in case you don’t believe me. Of course, this isn’t stopping teenage boys from walking to high school in just shorts and sweatshirt hoodies, which […]
November 24th, 2025
ID Things to Be Grateful for — 2025 Edition
Looking back on these annual Thanksgiving posts, I notice an odd pattern: every few years, the intro turns into a kind of apology. As in, Yes, I know the title sounds upbeat, please don’t attack me. The world feels heavy, the ID bad news scrolls by, and there I am writing about gratitude. A colleague […]
November 18th, 2025
When AI Gets the Medical Advice Wrong — and Right
A journalist recently reached out to ask about the shingles vaccine. We mostly talked through the usual topics — how common shingles is, why the vaccine works so well, and side effects. Plus, the whole topic of zoster vaccination has been much in the news recently given studies associating receipt of the vaccine with a […]
November 13th, 2025
Hot Takes from IDWeek: CDC, COVID, and Two Doses of Dalbavancin
Every so often, you sit down for what’s supposed to be a lighthearted conversation and end up somewhere not just fun, but deeply enjoyable and even profound. That’s what happened when I joined my friends and ID colleagues Drs. Buddy Creech (Vanderbilt, pediatric ID) and Mati Hlatshwayo Davis (Washington University, public health expert) for the […]
November 7th, 2025
Favorite ID Fellow Consults: Johns Hopkins Edition
Just back from a visit to the Infectious Diseases Division at Johns Hopkins, thanks to the kind invitation of current ID chief Dr. Amita Gupta and her predecessor, Dr. David Thomas. On a personal note, this visit was only a few decades late. When I applied to medical school, Hopkins never invited me to interview […]
October 28th, 2025
Two Covid Vaccine Studies — One Actionable, the Other Not So Much
As we await the results of placebo-controlled Covid-19 vaccine studies, what are we clinicians to do when our patients ask us whether they should get a booster this fall? What once was a no-brainer in the early days of limited immunity to the virus — and the spectacular results of the first placebo-controlled trials — […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- The Things We Carry January 10, 2026The ID, the pen, the epinephrine, the scalpel are the nonnegotiables, the necessities for any hospital shift. But they are not the only things a physician carries, and certainly not the most burdensome.
- RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults January 8, 2026In this open-label, randomized trial, the RSV vaccine reduced the incidence of hospitalization for RSV-related respiratory tract disease as compared with no vaccine among adults 60 years of age or older.
- Serogroup Switching in Neisseria meningitidis with Dual Antibiotic Resistance January 8, 2026Serogroup switching away from serogroup Y has been identified in the major ciprofloxacin-resistant Neisseria meningitidis strain, which may impede identification of ciprofloxacin-resistant cases of N. meningitidis infection.
- Case 1-2026: A 50-Year-Old Woman with Fever and Abdominal Pain January 8, 2026A 50-year-old woman was admitted to the hospital because of fever and abdominal pain after visiting rural Brazil. Shock and disseminated intravascular coagulation developed. A diagnosis was made.
- Direct-Acting Antiviral Agents in Hepatitis C–Associated Indolent Lymphomas January 1, 2026In an update of the BArT study, direct-acting antivirals led to durable responses in HCV-associated indolent B-cell lymphomas, with 6-year progression-free survival of 66% and no relapses after a complete response.
- The Things We Carry January 10, 2026