HIV and ID Observations

November 13th, 2025

Hot Takes from IDWeek: CDC, COVID, and Two Doses of Dalbavancin

Every so often, you sit down for what’s supposed to be a lighthearted conversation and end up somewhere not just fun, but deeply enjoyable and even profound. That’s what happened when I joined my friends and ID colleagues Drs. Buddy Creech (Vanderbilt, pediatric ID) and Mati Hlatshwayo Davis (Washington University, public health expert) for the […]

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November 7th, 2025

Favorite ID Fellow Consults: Johns Hopkins Edition

Just back from a visit to the Infectious Diseases Division at Johns Hopkins, thanks to the kind invitation of current ID chief Dr. Amita Gupta and her predecessor, Dr. David Thomas. On a personal note, this visit was only a few decades late. When I applied to medical school, Hopkins never invited me to interview […]

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October 28th, 2025

Two Covid Vaccine Studies — One Actionable, the Other Not So Much

As we await the results of placebo-controlled Covid-19 vaccine studies, what are we clinicians to do when our patients ask us whether they should get a booster this fall? What once was a no-brainer in the early days of limited immunity to the virus — and the spectacular results of the first placebo-controlled trials — […]

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October 16th, 2025

Another Bad Week for the CDC, and a Personal Note

On Friday night, news broke that more than a thousand CDC staff received layoff notices — including people who track measles outbreaks, analyze data to craft policy, monitor employee safety, and, remarkably, recent Epidemic Intelligence Service (EIS) fellows (the early-career epidemiologists who often show up first when something alarming appears). Now, nearly a week later, […]

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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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