An ongoing dialogue on HIV/AIDS, infectious diseases,
October 27th, 2008
Antibiotics as Placebos?
This article in the BMJ is geting lots of news: Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis. A “small but notable proportion (13%) of physicians reported using antibiotics.” My first instinct was surprise that the rate was this low, but then I remembered that […]
October 21st, 2008
Back to School, Day 4: PEP and More PEP
After a lecture on HIV for Primary Care Providers in our course last week, the most controversial topic was, not surprisingly, the use of post-exposure prophylaxis (PEP) for both occupational and non-occupational exposures. And today, after an entire lecture on PEP to a group of HIV providers in our AIDS course, again the subject drew […]
October 18th, 2008
Back to School, Day 2
During the course, often the best questions and anecdotes come during the breaks. Here are a few: Tons of questions about our favorite nemesis, MRSA. What works for chronic carriers? How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient? What if the […]
October 15th, 2008
Back to School, Day 1
We offer two post-graduate courses each year, one entitled Infectious Diseases in Primary Care, and the other AIDS Medicine: An Intensive Case-Based Course. The Primary Care one started today, the AIDS course starts on Monday. (Both are equally fascinating. I am entirely unbiased.) What is so striking is that the participants — and content — […]
October 1st, 2008
Deadlines of Note
Just a reminder of some interesting deadlines/events out there, in case you were too wrapped up sharpening pencils for tomorrow’s Vice Presidential debate: As of today, Medicare will no longer reimburse hospitals for medical errors — which includes some hospital-acquired infections. According to this article, several other payors (including private insurers) are using this as a […]
September 29th, 2008
Required Reading: The Value of ID Specialists
In the most recent issue of Clinical Infectious Diseases, there’s a comprehensive review of the value of an ID specialist from the perspective of non-patient care activities. Covered in particular are: Antibiotic stewardship Infection control Monitoring rates of nosocomial infections Managing health care worker “well-being and exposures” Also included are tables listing dozens of studies quantifying […]
September 27th, 2008
Crunchy Frog?
One of the ID fellows just received this curbside consult: A primary care doctor paged me because a patient of his just discovered a dead frog in the salad she was eating, and wanted to know what to do. How about, “Don’t eat it!” But there are definitely some things in our field you just […]
September 18th, 2008
C. diff: The cure for antibiotic abuse
Even with market doom-and-gloom dominating the news, there’s a good article in yesterday’s Wall Street Journal on Clostridium difficile (C. diff). It gives an accurate summary (in lay language) of the problem, several pertinent clinical anecdotes, and quotations from national experts. But this part in particular caught my eye: She says that among other measures, the […]
September 10th, 2008
Yes, TNF blockers increase infection risk. Now what?
So the FDA has issued (another) warning about TNF (tumor necrosis factor) blockers and increased infection risk, this time focusing on fungal infections, in particular histoplasmosis. TNF blockers are used for treatment of rheumatoid arthritis, Crohn’s Disease, ankylosing spondylitis, psoriasis, and a wide range of other autoimmune diseases, both in approved and in off-label use. ID/HIV […]
September 5th, 2008
West Nile Virus and Friday Night Lights
The town of Braintree, just south of Boston, has cancelled Friday night high school football games until the first frost of the year due to concerns about West Nile. Apparently the campus has a lake and wetlands, good breeding grounds for mosquitoes. “This is all in the name of safety,” says the school headmaster. (If someone […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- Probable Japanese Encephalitis Virus Transmission through Organ Transplantation March 26, 2026Infection with Japanese encephalitis virus, a mosquito-borne flavivirus, was identified in a patient who received a liver transplant from a donor who resided in California.
- Brief Report: Prime Editing for p47phox-Deficient Chronic Granulomatous Disease March 26, 2026In this study, gene editing with a prime editor was used to treat two persons with chronic granulomatous disease caused by a small deletion in the gene NCF1.
- Communicating about Vaccines in a Politically Contentious Climate March 26, 2026Recent changes in U.S. vaccine policy are sowing confusion and threatening the health of children and the wider population. How should pediatric clinicians communicate with parents to stem the damage?
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- Genetic Medicine — Primed and Ready March 26, 2026Immunodeficiency chronic granulomatous disease (CGD) is a rare disorder characterized by defects in a multiprotein complex that generates superoxide in phagocytic cells.1 Recurrent infections and formation of granulomas are hallmarks of X-linked and autosomal-recessive CGD, which is caused by variants in genes encoding individual subunits. As a monogenic...
- Probable Japanese Encephalitis Virus Transmission through Organ Transplantation March 26, 2026