An ongoing dialogue on HIV/AIDS, infectious diseases,
January 10th, 2010
Ceftobiprole’s Long Road to Approval Gets Longer
Cephalosporins with activity against MRSA are out there, but we don’t have them yet. Just recently, the leader of the pack, ceftobiprole, hit another roadblock: The FDA has indicated in its Complete Response Letter to Johnson & Johnson PRD that it has completed the review of the application and has determined that it cannot approve […]
January 1st, 2010
Top 10 Stories of the Year
No end-of-year wrap-up is complete without a “Top 10” list, and Journal Watch: AIDS Clinical Care is no exception. This year we did two lists, one chosen by the Editors, the other a numeric tally of what’s read on line by the Readers. The “When to start” issue was the top story from the Editors. […]
December 28th, 2009
Holiday Surprise: Generic Valacyclovir
Last week one of my patients went to refill a Valtrex prescription, and was offered generic valacyclovir for the first time. It made him nervous, so he requested I write a “brand-name only” script. I confess the existence of a generic formulation of valacyclovir — which according to the PharmD here has been available for […]
December 20th, 2009
Infections from Transplant Donors: Rare but Inevitable
Two kidney transplant patients are critically ill due to Balamuthia mandrillaris encephalitis they acquired from the organ donor: The same infection probably killed the organ donor, but it was not diagnosed; his doctors thought he had an autoimmune disease. Two other patients also received heart and liver transplants from the donor, but neither has become […]
December 13th, 2009
Infection and the ICU: Outcome Predictable, but Important
If you enrolled over 14,000 ICU patients into a study on a single day, and then did follow-up, what would you find regarding the relationship of infection to the outcomes of ICU stay and mortality? Just such a study was published in JAMA last week, and here are the not-so-stunning conclusions: Infections are common in […]
December 8th, 2009
Vancouver, Phishing Phlu Scam, Telavancin, and Cartoon
A few things to ponder as the flu activity (mercifully) declines, at least for now: Interested in evidence that HIV treatment has become staggeringly effective? Fully 87% of patients receiving treatment in the large British Columbia cohort have an HIV RNA < 50; not only that, the incidence of HIV drug resistance has declined more […]
November 30th, 2009
WHO HIV Treatment Guidelines Updated
This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course. Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing […]
November 20th, 2009
Ties Tied to Bugs
Are doctors’ neckties causing infections? That’s the implication of this Wall Street Journal piece: The list of things to avoid during flu season includes crowded buses, hospitals and handshakes. Consider adding this: your doctor’s necktie. … A 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center […]
November 7th, 2009
A Career in Infectious Diseases and “The Next Big Thing”
I was working with a medical intern in clinic this past week who is potentially interested in ID. After seeing our 3rd consecutive stable HIV patient, he asked me what I thought the next big challenge would be in our field — especially since HIV treatment has been “solved.” “Solved” might be stating it a […]
October 17th, 2009
Is Chronic Fatigue Syndrome Another Retroviral Disease?
Here’s a surprising report in Science: Studying peripheral blood mononuclear cells (PBMCs) from CFS patients, we identified DNA from a human gammaretrovirus, xenotropic murine leukemia virus-related virus (XMRV), in 68 of 101 patients (67%) compared to 8 of 218 (3.7%) healthy controls … These findings raise the possibility that XMRV may be a contributing factor […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- Challenging Claims of an Autism Epidemic — Misconceptions and a Path Forward January 17, 2026Autism research programs should focus on both causes and effective services and supports. Alarmist claims, chasing of debunked theories of causation, and further stigmatizing autism are counterproductive.
- Pneumocystis jirovecii Pneumonia January 17, 2026A 60-year-old man with recently diagnosed HIV infection presented with a 10-day history of fever, dry cough, and shortness of breath. A CT scan of the chest showed diffuse nodules and ground-glass opacities.
- 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.
- 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.
- 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.
- Challenging Claims of an Autism Epidemic — Misconceptions and a Path Forward January 17, 2026