An ongoing dialogue on HIV/AIDS, infectious diseases,
August 23rd, 2018
Eye Worm, MALDI-TOF, New Lyme Testing Approach, Dogs Fail as C. diff Testers, Uiyk (?), and More — A Summer Is Getting Shorter ID Link-o-Rama
A recent chilly spell here in Boston recalled a universal truth about aging — that summer seems to get shorter every year. As far as I can tell in my unscientific poll of everyone who will engage with me on this topic, there are no exceptions to this rule. Everyone thinks summer is shorter than […]
August 5th, 2018
Why Caring for People with HIV Is Still Great
Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. It’s one of the most commented-on pieces in the history of this blog. Read this for a typical response. Admittedly, it was kind of a downer — but it might […]
July 8th, 2018
Surgeon Who Was Denied Disability Insurance for Taking PrEP Tells His Story
Earlier this year, urology resident Dr. Philip Cheng appeared on the front page of the New York Times. Here was the headline: He Took a Drug to Prevent AIDS. Then He Couldn’t Get Disability Insurance. The piece understandably drew widespread attention, with sharp disapproval of the denial from ID specialists and public health officials. We […]
July 1st, 2018
Why Do Our Patients Think They Have Spider Bites?
We are currently in peak tick season here in the Northeastern United States. It might be hard for clinicians elsewhere to understand just how profoundly this changes our assessment of fevers and rashes. But consider this — ordering the trio of Lyme antibody, Anaplasma PCR, and Babesia PCR is as much a part of the […]
May 20th, 2018
Why the Dolutegravir Pregnancy Warning Is Important — and What We Should Do Now
Last week, in response to newly available surveillance data, multiple agencies issued a warning about the HIV integrase inhibitor dolutegravir (DTG) and pregnancy. The warnings cite an increased risk of neural tube defects in babies born to women who became pregnant while receiving the drug. From the U.S. Department of Health and Human Services: The concern […]
May 13th, 2018
Why Experienced HIV/ID Doctors Leave Clinical Practice
Three of my good friends — they’re way more than just colleagues after all this time — in the HIV/ID world have left clinical practice recently. Abigail (Abbie) Zuger, Joel Gallant, and Chuck Hicks, each of them brilliant in different ways, won’t be caring for people with HIV anymore, something they’ve all been doing since […]
April 16th, 2018
Hepatitis C Positive Organ Donors — Coming Soon to a Transplant Center Near You
There’s one immutable fact in solid organ transplantation — the number of patients awaiting transplant exceeds the number of available organs. This shortage means that ethical, medically safe strategies to increase the donor pool are always a high priority. One such strategy would be to allow transplants from people who have chronic hepatitis C. If […]
March 18th, 2018
Why with Extremely Resistant Infections, It’s Extremely Important to Consult ID
Since the only procedures most of us Infectious Diseases doctors do with any regularity are biopsies of patient medical records, we have to justify our existence in other ways — such as collecting data on how our expertise improves patient outcomes. There are a bunch of these papers published, with this one being the most […]
February 25th, 2018
Is Self-Administered Postexposure Prophylaxis Another Viable Option for HIV Prevention?
Most of the pivotal trials of pre-exposure prophylaxis (PrEP) have used daily therapy. The lone exception is the IPERGAY study. Men at high risk for acquiring HIV took two tablets of tenofovir DF/emtricitabine (TDF/FTC, Truvada) before sex, and one tablet the next 2 days. The strategy was highly effective in preventing HIV acquisition, and intermittent PrEP […]
February 19th, 2018
Can We Solve the Morass of Outpatient Intravenous Antibiotic Therapy?
If you want to get an ID doctor riled up, here are a few reliable strategies: Get an ID consult on a complex patient just to summarize the chart for your discharge summary. Endorse the view that procedural doctors deserve their vastly higher salaries than MDs in cognitive specialties. Prescribe azithromycin for patients with bad […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
FROM NEJM — Recent Infectious Disease Articles- Borrelia burgdorferi Infection and Erythema Migrans January 15, 2026Expansion of the range of the lone star tick, a vector for southern tick-associated rash illness, has led to overlap with the range of the Lyme disease vector Ixodes scapularis, which may cause diagnostic uncertainty.
- Case 2-2026: A 63-Year-Old Man with Pulmonary Nodules, Liver Mass, and Vision Loss January 15, 2026A 63-year-old man was admitted to the hospital because of fever, cough, and vision loss in the right eye. He had pulmonary nodules, a liver mass, and multiple brain lesions. A diagnosis was made.
- Primary Palmoplantar Pustulosis January 15, 2026A 60-year-old man with a 30-pack-year smoking history presented with a 2-year history of a painful rash on his palms and soles. Numerous pustules with erosions, crusting, and surrounding erythema were noted.
- The Things We Carry January 15, 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.
- 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.
- Borrelia burgdorferi Infection and Erythema Migrans January 15, 2026