February 4th, 2026

Mystifying Abbreviations — Infectious Diseases Edition

Jumbled letters Photo

Motivated by an attending stint on the general medical service, I once wrote a post here called, “Mystifying Abbreviations on Medical Rounds.” It proved to be quite popular, so I’m pleased to inform you that saying “RUQUS” (right upper quality ultrasound) and “G and G” (glucan and galactomannan) have truly entered the vernacular, especially here at my hospital.

(I’m convinced we remain the #1 utilizers of beta glucan testing in the world, for better and for worse. The low-risk case with the barely positive beta glucan triggers a spectacular number of unnecessary ID consults.)

Now, I’m back with a similar topic, only this time with an ID-specialty focus. My inspiration this time wasn’t the inpatient medical service, but an email a colleague wrote that truly stretched the limitations of my acronym knowledge. I found myself re-reading several sentences, wondering “huh?” and “what the …?” multiple times, not able to decipher their meaning even within the context of the email.

Here, for the record, is part of that email:

RCTs on provision of SUD tx with PrEP and ART like MHUs and PNs  — RCT just completed NIDA funded, CROI abstract to come … also LAI PrEP and ART plus SUD tx to PWUD …

So here’s the challenge: I’ve listed a bunch of ID-related acronyms below and made brief comments that sometimes are hints — and other times are just the first thing that popped into my head. You, the wise readers, will offer your suggestions about what they mean. Some should be easy, some might be truly head-scratchers, but that’s part of the fun.

Have at it.

IGRA — frequently ordered, almost as frequently misinterpreted

PWID — very similar to PWUD, but somehow different enough to justify a separate acronym

BSI — not to be confused with BSA

CLABSI — BSI, but now with administrative consequences

CRBSI — similar to CLABSI, but until recently, I hadn’t heard this one so including it here

DILI — sounds cute; very much not

VRE — a three-letter word that can force you stop citalopram

CRE — looks like VRE, behaves worse

CPE — related to CRE, but more specific

ESBL — aspires to be pronounced as a word like MRSA instead of letter-by-letter, which it always is

PSSA — say this one it as it’s written and you too can sound like you’re from South Boston

LAI — add it to your coffee in the morning

MDR — vague, ominous, and highly contextual

XDR — MDR, but worse

RIPE — not for XDR

BCx — the lowercase “x” at the end is different from the X in XDR, and stands for … nothing, though UCx uses it too

PDRRRRRRR, or “pirate bacteria”

SUD — encompasses OUD, AUD, and StUD — and you know what those are, right?

TDM — sounds straightforward until you need to interpret and act on the results

EHE — bold vision, weird acronym

IRIS — pretty name, not so pretty to manage

LTBI — may need RIPE “lite,” and importantly non-infectious

PsA — no one can explain why the third letter is capitalized

bNAbs — another one with inscrutable capitalization rules — I mean, why not BNAbs?

TOC — beware lingering molecules of dead bugs!

OPAT — does not refer to Irish people named “Patrick”

EOT — you’ll suffer if you don’t specify this for your OPAT patients, those named Patrick or otherwise

AYALHIV — well, I know what the last three letters stand for

Of course, abbreviations and acronyms exist for a reason — they save time, space, and keystrokes, and they let us sound efficient while we’re still figuring things out. But when they pile up unchecked, they turn even a straightforward clinical discussion into something that feels like a badly encrypted message, or that 6-character jumble (the confirmation code) that you get with every flight. People are well within their rights to say, on hearing a new one, what does that mean?

Before wrapping up, here’s one of the more absurd abbreviation sagas in modern medical history. For years, we’ve been required to check off “GC modifier” on every patient we see with a trainee in order to get credit for their documentation. Fine.

But no one — and I mean no one — knows what “GC” actually stands for. Not physicians. Not coders. Not compliance officers. It exists solely as two letters that must be clicked, lest the visit somehow not count. Which may be the purest example of an acronym achieving total bureaucratic independence from meaning — and a fitting way to end a discussion about how shorthand, once created, takes on a life of its own.

9 Responses to “Mystifying Abbreviations — Infectious Diseases Edition”

  1. Scott Helmers, MD says:

    A frustration for me is use of acronyms within published medical articles. Unable to read everything, I often scan for applicable information. So many times, unfortunately, to understand that information I must search back in that article to try to learn the meaning of an acronym. I once suggested to either JAMA or NEJM that each article simply at the beginning or end, list any acronym in the article with the definition. I cannot see how that would be a terrible imposition on the author. My suggestion went nowhere, of course.

    • Paul Sax says:

      Excellent point. We editors try to make the authors define them all at the time of first usage, but some slip by.
      Perhaps a future post, “Mystifying Abbreviations in Medicine — Medical Literature Edition.”
      -Paul

  2. Loretta S says:

    Had to laugh at the “GC” modifier in documentation. Heaven forbid you see a Medicare patient and do not click the correct modifier, or forget to include it. The number of meaningless 2-letter modifiers is mindboggling, as are the number of meaningless numerical modifiers AND alphanumeric modifiers: https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00003604 Well, at least they “will always be 2 digits”. Except it might be 1 digit and 1 letter, or 2 letters.

  3. Jonathan Blum says:

    Easy enough. EHE stands for epithelioid hemangioendothelioma, or is it executive health exam? I don’t want either of those. DILI is the capital of East Timor. And IGRA stands for it’s gonna react anyway.

    • Paul Sax says:

      IGRA stands for it’s gonna react anyway

      Ha, good one. EHE is ID related — that’s your second hint. Your first hint was in the main text!
      – Paul

  4. Scott Helmers, MD says:

    The problem with definition only at the first use does mean searching back for that first use. That is why I suggest a simple table with complete listing together of any acronyms in the article. A list at either the beginning or before the references would mean quick and simple finding of the meaning of any and all of the acronyms.

  5. Guillermo Prada says:

    Agree.For most everybody complicates back and forth the reading of the medical literature. For us, even being bilingual, it implies an extra effort to translate what for many of you can be routine. It does not take a long time or a long space in the paper and it avoids many times the interpretation. By the way, it took a long time for me to know what MAGA ment! Guillermo Prada, MD, FACP, FIDA

  6. Liz Jenny says:

    Language evolves.
    On my first day as third year medical student on medicine, I still remember my utter befuddlement at all the abbreviations–medicine seemed like a foreign language.

  7. Neil Siegel says:

    Can’t help with medical literature, but PLEASE learn to use auto-correct dictionaries in your EHR clinical notes. You can still type just 3-4 letters, but the rest of us can read the full names of the abbreviation that’s so obvious to you but completely mysterious to the rest of us (Yes, I’m looking at you, Ophthalmology!)

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Associate Editor

NEJM Clinician

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