An ongoing dialogue on HIV/AIDS, infectious diseases,
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 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 — […]
October 16th, 2025
Another Bad Week for the CDC, and a Personal Note
On Friday night, news broke that more than a thousand CDC staff received layoff notices — including people who track measles outbreaks, analyze data to craft policy, monitor employee safety, and, remarkably, recent Epidemic Intelligence Service (EIS) fellows (the early-career epidemiologists who often show up first when something alarming appears). Now, nearly a week later, […]
October 10th, 2025
DOTS: Optimism Around a “Negative” Dalbavancin Trial
The DOTS randomized clinical trial of dalbavancin versus standard-of-care for Staph aureus bacteremia (SAB) just landed in JAMA, where it undoubtedly will be featured in numerous ID, hospitalist, and medical resident journal clubs over the next several months. Proof: one of our great second-year ID fellows tagged it immediately for his journal club literally the […]
October 3rd, 2025
Update on Louie and One Interesting ID Fact
First, I want to express my sincere thanks to all those who commented, emailed, and texted about our dog Louie. My family and I truly appreciate the concern and the feelings people shared about their own dogs. And how about these selected bits of wisdom, posted by Dr. Gordon Huth? “Dogs’ lives are too short. […]
September 4th, 2025
End-of-Summer Musings — Hepatitis B, Dalbavancin, Alpha-Gal, and More
The last time I did one of these quick “musings” posts, I listed 21, and someone asked me, “Why 21?” The answer — obviously — is that I originally planned on writing 20, but then had to add a 21st, just because that’s exactly how many points you need to win a ping pong game. […]
August 6th, 2025
Does the Fact That AI Is Brilliant at Writing “Learning Objectives” Prove They’re Not Really Needed?
Recently, I was invited to speak at a primary care conference on a terrific topic: “Can’t Miss Diagnoses in ID for the PCP.” Love it. So many great examples come to mind — endocarditis, Lemierre syndrome, vertebral osteomyelitis, acute HIV. A wonderful opportunity to teach about the “rare but there” diagnoses hidden among everyday outpatient […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
FROM NEJM — Recent Infectious Disease Articles- Interactive Perspective: Measles December 18, 2025This Double Take video reviews evidence-based recommendations on measles prevention and management and explores commonly asked questions about the measles virus and infection.
- Noninferiority of One HPV Vaccine Dose to Two Doses December 18, 2025In this trial, one dose of an HPV vaccine was noninferior to two doses in preventing HPV type 16 or 18 infection.
- From Crisis to Action — Policy Pathways to Reverse the Rise in Congenital Syphilis December 18, 2025In recent years, cases of congenital syphilis have surged. This trend reflects both prenatal care gaps and systemic issues, including failures in testing, treatment, and public health infrastructure.
- Contact Precautions for MRSA and Vancomycin-Resistant Enterococcus December 18, 2025This feature about the use of contact precautions in the hospital for patients with MRSA or VRE offers a case vignette accompanied by two essays, one supporting continuing the use of contact precautions and the other recommending discontinuing them.
- Evidence to Action — Single-Dose HPV Vaccination and Cervical HPV Infection December 18, 2025Kreimer and colleagues now report in the Journal1 the results of the ESCUDDO trial, which showed that the efficacy of a single dose of either a bivalent human papillomavirus (HPV) vaccine or a nonavalent formulation was similar to that of the standard two-dose schedule. This randomized trial...
- Interactive Perspective: Measles December 18, 2025