An ongoing dialogue on HIV/AIDS, infectious diseases,
September 29th, 2008
Required Reading: The Value of ID Specialists
In the most recent issue of Clinical Infectious Diseases, there’s a comprehensive review of the value of an ID specialist from the perspective of non-patient care activities. Covered in particular are: Antibiotic stewardship Infection control Monitoring rates of nosocomial infections Managing health care worker “well-being and exposures” Also included are tables listing dozens of studies quantifying […]
September 18th, 2008
C. diff: The cure for antibiotic abuse
Even with market doom-and-gloom dominating the news, there’s a good article in yesterday’s Wall Street Journal on Clostridium difficile (C. diff). It gives an accurate summary (in lay language) of the problem, several pertinent clinical anecdotes, and quotations from national experts. But this part in particular caught my eye: She says that among other measures, the […]
September 10th, 2008
Yes, TNF blockers increase infection risk. Now what?
So the FDA has issued (another) warning about TNF (tumor necrosis factor) blockers and increased infection risk, this time focusing on fungal infections, in particular histoplasmosis. TNF blockers are used for treatment of rheumatoid arthritis, Crohn’s Disease, ankylosing spondylitis, psoriasis, and a wide range of other autoimmune diseases, both in approved and in off-label use. ID/HIV […]
August 22nd, 2008
We have met the enemy … and it is MRSA
In Jerry Groopman’s recent New Yorker piece on antibiotic-resistant bacteria, he quotes Dr. Louis Rice from the Cleveland VA, who uses the term “ESKAPE” bacteria: an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa, and Enterobacter. Nothing against the mostly gram-negative nasties in this list (and the focus of the New Yorker […]
August 8th, 2008
More from Mexico City
A bit more travelogue from the XVII International AIDS Conference: It’s impossible to see everything you want at such a large, sprawling conference, sometimes because of conflicting meetings, sometimes because the room is full, sometimes because of a feeling analagous to being in a giant museum for too many hours — fatigue just takes over. But […]
July 29th, 2008
Antiretroviral Rounds: Immediate ART After an OI — Are We There Yet?
A few things have been guaranteed to get widely divergent views among HIV specialists — and one of them was when to start antiretroviral therapy in someone presenting with an acute OI. However, in the latest Antiretroviral Rounds, our two experts (Raphy Landovitz and Phil Grant/Andrew Zolopa) kind of agreed. They’d start immediately. At least that’s […]
July 25th, 2008
Word salad: Jalapenos, abacavir, doripenem, and PAVE
Some miscellaneous recent items from the ID/HIV world jumbling around this Friday: Tomatoes are off the hook — it’s the jalapenos that likely caused the recent salmonella outbreak. Since this is the only time of year that tomatoes are even edible in this part of the world, I for one am quite relieved. I am sure […]
July 19th, 2008
“Floxins” and the black-box warning: Anyone notice? Anyone care?
Fluoroquinolones — the “floxins”, every medical house officer’s favorite antibiotic class — will carry a black-box warning about the risk of tendinitis and tendon rupture. We’ve known about this side effect for years, why now the change? In FDA speak: FDA’s recent evaluation of the medical literature and the post-marketing adverse event reports submitted to […]
July 11th, 2008
M184V: So many options, but does that include TDF/FTC/EFV?
Co-formulated TDF/FTC/EFV (Atripla) is a nifty bit of pharmacologic packaging (ever so much more so since it involves collaboration between two different pharmaceutical companies, ahem) — and our patients have noticed. All of us who practice HIV medicine have been asked for the “one pill” treatment; often these requests make sense, sometimes they don’t. It’s easy to […]
July 6th, 2008
HIV Testing: The Bronx is Up …
So the New York City Public Health Department would like to have every adult living in the Bronx tested for HIV. The Times coverage of the effort cites the best reason for reason for such a move — the high death rates from the disease, and the cause: Public health officials attribute this [the deaths] to […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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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