An ongoing dialogue on HIV/AIDS, infectious diseases,
February 4th, 2026
Mystifying Abbreviations — Infectious Diseases Edition
Motivated by an attending stint on the general medical service, I once wrote a post here called, “Mystifying Abbreviations on Medical Rounds.” It proved to be quite popular, so I’m pleased to inform you that saying “RUQUS” (right upper quality ultrasound) and “G and G” (glucan and galactomannan) have truly entered the vernacular, especially here […]
January 27th, 2026
Florida Moves to Cut AIDS Drug Assistance Program — and Drops the Most Prescribed HIV Regimen in the Country
We prescribers of HIV medications — and our patients — have for the most part lived in a very privileged space in this country. Newer drugs with advantages in efficacy, safety, or convenience have generally been covered, either by private insurance or by government drug-assistance programs. Drug coverage was historically so good that it even […]
January 21st, 2026
Rabies Is Terrifying — and the Challenge of Managing a Low Risk of a Dreadful Disease
Three case reports of human rabies recently appeared in the MMWR. Reading each one served as a reminder of just how horrifying this infection is when it strikes — which very fortunately is quite rare in our country. Two cases were domestic and followed recognized direct bat exposures with no post-exposure preventive measures taken. Here are […]
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 […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- A Pediatrician’s Dilemma — Pushing Back against CDC Guidance in the Exam Room February 7, 2026When a mother cites the CDC as her source of dangerous misinformation about vaccines, her child’s pediatrician struggles: how hard can a doctor push back without destroying the trust built over a lifetime?
- A Matter of Time February 5, 2026A 29-year-old woman with active opioid, alcohol, benzodiazepine, tobacco, and cocaine use disorders and recent intravenous drug use presented with acute onset of chills and increased pain and drainage of chronic wounds in both legs.
- Antigenic Drift and Antivaccine Shift in the 2025–2026 Influenza Season February 4, 2026Both viral and host factors have contributed to the intensity of influenza activity during the 2025–2026 season. Some of these factors can be managed, whereas others are largely beyond human control.
- Case 4-2026: An 80-Year-Old Woman with Cough and Hypoxemia January 29, 2026An 80-year-old woman was admitted to the hospital because of cough and hypoxemia (oxygen saturation, 83%). CT of the chest showed diffuse ground-glass opacities in both lungs. A diagnosis was made.
- The Essential Role of States in Protecting Immunization Access January 29, 2026In the face of U.S. federal policy shifts that threaten to destabilize vaccine access and weaken clinical guidance, states can step in and protect their residents.
- A Pediatrician’s Dilemma — Pushing Back against CDC Guidance in the Exam Room February 7, 2026