An ongoing dialogue on HIV/AIDS, infectious diseases,
February 26th, 2026
Some Ruminations on CROI — Still the Best HIV Meeting
CROI, which just wrapped up in Denver, is not like other scientific meetings — it’s quirky. Let me count the ways. There’s the name — the Conference on Retroviruses and Opportunistic Infections — coined in the early 1990s, when fax machines were cutting-edge technology. It’s pronounced to rhyme with boy, by the way. No one […]
February 17th, 2026
Two Things Can Be True: The FDA Process Was Inconsistent, and the mRNA Vaccine Data Were Disappointing
Any time I write about vaccines, especially mRNA vaccines, things get dicey. Any negative comments might fuel attacks from one wing that I’m trying to fuel vaccine doubt, or (from another), hostility toward corporate innovation and profits. And of course, there’s a small but vocal minority that believes that all vaccines are inherently harmful; it’s […]
February 12th, 2026
Sometimes You Just Need to Get Input from a Real Human Being
If you’re not using AI in clinical medicine yet, allow me to strongly recommend you start — soon. Like now. It’s a phenomenal tool for looking things up quickly. I’d call it the future of information retrieval, but that future has already arrived. OpenEvidence is currently leading the pack, at least around here. Doximity is […]
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 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 […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- Primary Measles Infection February 26, 2026A previously healthy man presented with a 5-day history of fever, nausea, and vomiting and a 2-day history of an itchy rash. Examination showed an exanthem consisting of minute macules and subtly elevated papules.
- Tecovirimat for the Treatment of Mpox February 26, 2026Mpox continues to spread in many communities. Tecovirimat has activity against orthopoxviruses in vitro. In a phase 3 trial involving patients with acute mpox, tecovirimat showed no evidence of clinical activity.
- Microbial Flora in War Wounds from the Ukrainian Front Line February 26, 2026Battlefield injuries are often contaminated with potentially infecting microbes. In this study, swabs obtained in the field after injury were profiled. Microbes and potential antimicrobial-resistance genes were characterized.
- AI-Enabled Precision-Education Systems — Transforming Lifelong Learning in Medicine February 26, 2026Trainees’ paths to safe, independent practice are variable. Artificial intelligence could help accelerate implementation of competency-based medical education to support individualized development.
- From Efficacy to Access in Long-Acting HIV Therapy February 26, 2026Over the past three decades, advances in antiretroviral therapy (ART) have dramatically improved life expectancy, decreased frailty, and improved quality of life for persons with human immunodeficiency virus (HIV).1,2 These gains have accrued primarily among those who can reliably access health care and adhere to daily treatment. For...
- Primary Measles Infection February 26, 2026