HIV and ID Observations

October 10th, 2025

DOTS: Optimism Around a “Negative” Dalbavancin Trial

The DOTS randomized clinical trial of dalbavancin versus standard-of-care for Staph aureus bacteremia (SAB) just landed in JAMA, where it undoubtedly will be featured in numerous ID, hospitalist, and medical resident journal clubs over the next several months. Proof:  one of our great second-year ID fellows tagged it immediately for his journal club literally the […]

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October 3rd, 2025

Update on Louie and One Interesting ID Fact

First, I want to express my sincere thanks to all those who commented, emailed, and texted about our dog Louie. My family and I truly appreciate the concern and the feelings people shared about their own dogs. And how about these selected bits of wisdom, posted by Dr. Gordon Huth? “Dogs’ lives are too short. […]

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September 4th, 2025

End-of-Summer Musings — Hepatitis B, Dalbavancin, Alpha-Gal, and More

The last time I did one of these quick “musings” posts, I listed 21, and someone asked me, “Why 21?” The answer — obviously — is that I originally planned on writing 20, but then had to add a 21st, just because that’s exactly how many points you need to win a ping pong game. […]

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August 6th, 2025

Does the Fact That AI Is Brilliant at Writing “Learning Objectives” Prove They’re Not Really Needed?

Recently, I was invited to speak at a primary care conference on a terrific topic: “Can’t Miss Diagnoses in ID for the PCP.” Love it. So many great examples come to mind — endocarditis, Lemierre syndrome, vertebral osteomyelitis, acute HIV. A wonderful opportunity to teach about the “rare but there” diagnoses hidden among everyday outpatient […]

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July 25th, 2025

Who Gets Sent to ID Clinic? A Field Guide to Outpatient Referrals

Sometimes people ask me what kind of cases get referred to ID doctors in the outpatient setting. Despite what the latest television series might suggest, it’s rarely suspected Ebola (fortunately) or Tsutsugamushi fever — a disease that is much more fun to say by its Japanese name than its common one, scrub typhus. (In Japanese, “tsutsuga” […]

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July 17th, 2025

Ceftriaxone Is a Narrow Antibiotic Now — and Other Musings

In no particular order, 20 things I’ve found interesting lately — a mix of ID (mostly), language quirks, clinical stuff, even tennis, and an apology (#21) at the very end. Bonus videos embedded because we all need a break. 1. Isn’t it amazing how, over time, an antibiotic once considered “broad spectrum” later becomes the […]

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July 7th, 2025

Two Pandemics, Compared: Reflections on HIV and COVID-19

“Dr. Sax, what’s it like to have lived through two pandemics as an ID doctor?” The question came from a brand-new intern during afternoon sign-out. I took a breath — because wow, were they different. HIV: It Felt Like A Calling, One Miraculously Rewarded I started my internship in 1987, six years after the first […]

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June 20th, 2025

Federal HIV Guidelines Face a Shutdown — A Critical Loss for Clinicians and Patients

Each week, our HIV clinical group gathers to review active patients, share updates, and celebrate good news. On our whiteboard, we list four columns: Inpatients, Outpatients, Issues, and Celebrations. This week, under “Issues,” one of my colleagues wrote: HIV Guidelines:  ☹️ Yes, you read that right. This week, we learned that the federal HIV guidelines […]

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June 12th, 2025

Why the Sudden Firing of ACIP Members Should Put Every Clinician on High Alert

There are certain irrefutable verities when, like me, you’re an infectious diseases specialist married to a pediatrician. Here are our top two, which are deeply interrelated: Infectious deaths in children, or severe illnesses that lead to lifelong disability, are more devastating than similar events in adults. Each such case in a baby or child is […]

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June 6th, 2025

How ID Doctors Get Paid, Part 3: The Grab Bag Edition

If you’ve made it this far, congratulations! You’re now deep into the ID Reimbursement Rabbit Hole. Part 1 and Part 2 covered how ID doctors contribute immense value through patient care, stewardship, infection control, travel clinics — proudly fighting along the way for appropriate compensation as the “Loss Leaders” of the hospital. (Did you get […]

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