An ongoing dialogue on HIV/AIDS, infectious diseases,
April 2nd, 2013
Banner Day for ID on Physician’s First Watch, and a Big Pitch to Sign Up Now
Every weekday morning, right around the time the rest of my family gets up, the smart people at Physician’s First Watch send me an email listing the top medical news stories of the day. Imagine my delight yesterday when the following were deemed worthy for specific mention: Coccidioidomycosis! Valley fever cases on the rise in the […]
March 28th, 2013
Poll: How Often Do You Measure CD4 Cell Counts?
Over in Clinical Infectious Diseases, a recent study pretty much nails the fact that routine measurement of CD4 cell counts in clinically stable patients is an all but useless exercise. As summarized by Abbie Zuger in Journal Watch, here’s the key finding: When patients with an unrelated cause for an alteration in CD4-cell count such […]
March 23rd, 2013
ID Doctors, Pets in the Medical History, and a Cute Puppy
One of the things Infectious Disease doctors get teased about by our non-ID colleagues is our inclusion of pets in medical histories. It’s part of the social history, where we list a grab bag of potential “exposures” that increase the risk of infection — where someone is from, what they do, plus travel, dietary practices, […]
February 24th, 2013
Solve This Problem Please — Microbiology Results in Electronic Medical Records
Our hospital and affiliated practices have had electronic medical record (EMRs) of some sort for decades, so I’ve had my chance to try my hand at multiple “platforms,” both commercial and home-brew. (Weirdly — and I kid you not on this — a version of the first iteration from the 1980s is still around, running […]
February 17th, 2013
An Adherence Intervention That Works — But There’s a Catch
In a previous post, we reviewed the various flavors of medication non-adherence, and concluded with this tantalizing line: Next up: An Adherence Intervention that Actually Works — But There’s a Catch Well here it is, just published online in JAMA Internal Medicine. Dr. Robert Gross (a long-time HIV adherence researcher from U Penn) and colleagues […]
February 13th, 2013
Medication Adherence: The Final Frontier
Treatment of HIV has become so amazingly effective that when it fails, it’s no overstatement to say that it’s usually because the patient is not taking the medications. There are all kinds of provider-related reasons for this — inadequate patient education, prescribing and dispensing errors, failure to address language or education deficits — but here […]
February 7th, 2013
Ciguatera Is Hot (But It Could Be Cold)
The news about the cases of ciguatera fish poisoning in New York (NY Times here, MMWR here) reminded me of several unusual things about this form of “harmful algal bloom,” as it is so artfully called by the experts. Specifically, here are six: Symptoms are bizarre. It starts out like a standard case of gastroenteritis […]
January 21st, 2013
Must-Read Piece: “Fever of Too Many Origins”
Every so often a commentary gets something just right, and fortunately we have an example in this week’s New England Journal of Medicine. Entitled “Fever of Unknown Origin or Fever of Too Many Origins?”, it’s the best depiction I’ve read about doing ID consults in the intensive care unit (ICU). The author, Harold Horowitz (who has […]
January 17th, 2013
Why the Results of the C Diff Study (You Know Which One) Were No Surprise
In cased you missed it, fecal transplant — use of poop from a healthy donor, which is then infused into the colon either from above (nasogastric tube) or below (colonoscope) — is unquestionably the most effective treatment for people who have multiple recurrences of C. difficile colitis (C diff). We know this because of a […]
January 11th, 2013
How to Make the Flu Vaccine More Popular, Warts and All
In a week that saw both our hospital’s influenza-induced bed crunch make the New York Times, and my son, mother-in-law, and me succumb to this seasonal plague despite our receiving flu shots, I have been highly attuned to all things influenza. But the focus here will be on that perennial whipping boy of preventive Infectious Diseases, […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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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