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paul evan bunce, md

@paulbuncemd.bsky.social
1.3K followers 66 following 210 posts

internist, infectious diseases md, educator. he/him. toronto creator of firstcallid.ca and “the host response” podcasts.apple.com/ca/podcast/the-h… youtube.com/@firstcallid?si=vcip2Et…

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paul evan bunce, md @paulbuncemd.bsky.social · 06/10/2026
classic. i never had the opportunity to use gatifloxacin. mostly due to the work of some of my mentors who coauthored this nejm paper:
nejm.org
Outpatient Gatifloxacin Therapy and Dysglycemia in Older Adults | NEJM
Gatifloxacin has been associated with both hypoglycemia and hyperglycemia. We examined dysglycemia-related health outcomes associated with various antibiotics in a population of approximately 1.4 m...
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paul evan bunce, md @paulbuncemd.bsky.social · 03/10/2026
i could barely believe my eyes when i saw this relic today. has it really been 20 years? trivia: what side effect led to gatifloxacin falling off the market? #idsky
gatifloxacin promotional tote bag
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paul evan bunce, md @paulbuncemd.bsky.social · 22/09/2026
have we spent so much time teaching people not to "treat the culture" that we've started ignoring information that might actually be useful? a culture, on its own, doesn't make a diagnosis. but it can sometimes provide a clue. listen here for my confession (and feel free to disagree).
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paul evan bunce, md @paulbuncemd.bsky.social · 15/09/2026
i could not agree more with this. not only does the shingles vaccine do an amazing job preventing shingles, the additional benefits may be even more significant for those who receive it. it may also be the best thing to look forward to when someone is turning 50. www.cmaj.ca/content/198/...
cmaj.ca
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paul evan bunce, md @paulbuncemd.bsky.social · 11/09/2026
love this paper in @cmaj.ca regarding the benefits of the recombinant zoster vaccine. it's the additional benefits beyond preventing shingles that really stand out with this vaccine. www.cmaj.ca/content/198/...
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paul evan bunce, md @paulbuncemd.bsky.social · 10/09/2026
sometimes the act of taking a sexual history carries more value than the answers you get. #meded #STIsky
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paul evan bunce, md @paulbuncemd.bsky.social · 30/08/2026
😔 thanks for sharing your thoughts, though.
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paul evan bunce, md @paulbuncemd.bsky.social · 24/08/2026
there are patients/cases/situations where you just know every moment matters. not because they are critically ill, but because any misstep can mean missing their chance. there’s an art to anticipating these, knowing what’s around the bend, and finding a way to change the course. #meded #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 11/08/2026
if i could sum up this episode of the host response in one image… #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 10/08/2026
another solid episode of the Communicalbe podcast - a quarterly catch-up. podcasts.apple.com/ca/podcast/c... for some reason i felt they were speaking to me directly.
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paul evan bunce, md @paulbuncemd.bsky.social · 06/08/2026
viremic is a great educational podcast - basically a mini-curriculum covering the care of HIV-positive individuals. highly recommended.
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Reposted by paul evan bunce, md
Isaac Bogoch @isaacbogoch.bsky.social · 05/08/2026
New World screwworm has returned to the U.S. after more than 40 years, threatening livestock & wildlife (including potentially billions in economic losses). This is a solvable "one health" issue. Link: tinyurl.com/y3k8hc7p, with Jason Andrews and J. Scott Weese.
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paul evan bunce, md @paulbuncemd.bsky.social · 27/07/2026
a few pearls about fever that i find myself repeating to trainees (and patients): - fevers often resolve on their own, and it can be hard to know if any intervention changed the course - fevers tend to come at night. "afebrile so far today" is not always reassuring - fever ≠ infection #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 20/07/2026
i have had the privilege of caring for people who lived through the darkest years of the HIV epidemic. listening to their stories has changed me. this episode is an invitation to reflect on those stories and, perhaps, your own. #HIV #IDsky
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paul evan bunce, md @paulbuncemd.bsky.social · 30/06/2026
this one took a bit longer to write, and i'm not sure i got it exactly right. i've met people who can captivate a room, and i've met others who quietly make everyone around them better (and a select few who do both). this episode is really just my attempt to recognize both kinds of excellence.
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paul evan bunce, md @paulbuncemd.bsky.social · 15/06/2026
we offer you a 30 minute glimpse into the mind of brooke fraser in the latest episode of the bundle. particular thanks to our co-host, who prepared and recorded this episode while navigating several major life events (all positive). listen, share, follow, and enjoy.
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paul evan bunce, md @paulbuncemd.bsky.social · 01/06/2026
ever since recording this episode, i've noticed "translocation" showing up everywhere. maybe it's availability bias. maybe it's confirmation bias. or maybe translocation has quietly become the leading cause of infection in modern medicine.
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paul evan bunce, md @paulbuncemd.bsky.social · 23/05/2026
en.wikipedia.org/wiki/Lugdunum
en.wikipedia.org
Lugdunum - Wikipedia
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paul evan bunce, md @paulbuncemd.bsky.social · 23/05/2026
perhaps you meant to say, "a Lyon in sheep's clothing?" 🙂
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paul evan bunce, md @paulbuncemd.bsky.social · 19/05/2026
this episode was prompted by a colleague who reminded me, during an inpt consult, that she might be the one left sorting through unresolved issues after d/c. sometimes i inherit the loose ends. and, being honest, sometimes i create them. my aim here was more reflection than criticism.
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Reposted by paul evan bunce, md
FirstcallID @firstcallid.bsky.social · 17/05/2026
New episode of The Host Response 🎙️ D/C summaries often contain phrases like: “repeat imaging” “drain to be R/A” and several new medications with no stop date. 🤞 Episode 28 explores what happens when no one is assigned ownership, but someone ends up holding the bag. 👜 #MedEd #IDsky #PrimaryCare
podcasts.apple.com
Episode 28 - Holding the Bag: Discharge, Follow-Up, and Lost Ownership in Medicine
Podcast Episode · The Host Response: A FirstcallID Podcast · May 17 · 6m
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Reposted by paul evan bunce, md
FirstcallID @firstcallid.bsky.social · 07/05/2026
Also highlighted in the latest Bundle 4.0: "Towers of Silence," from 99percentinvisible. 99percentinvisible.org/episode/579-... A haunting story of Mumbai’s Towers of Silence, where the disappearance of vultures puts an ancient funerary tradition on the brink of collapse.
99percentinvisible.org
Towers of Silence - 99% Invisible
Situated right near downtown Mumbai, India is an area of about 55 acres of dense, overgrown forest. In one of the most populous cities in the world, this is a place where peacocks roam freely — a spac...
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paul evan bunce, md @paulbuncemd.bsky.social · 06/05/2026
ohhh, it’s about scabies.
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Reposted by paul evan bunce, md
FirstcallID @firstcallid.bsky.social · 05/05/2026
We covered a lot of material in Bundles 4.0 of The Host Response. Here is the link to the Gorgas Course "Case of the Week" - a great resource for those wanting to brush up on their tropical medicine knowledge. #idsky #tropmed
uab.edu
Case of the Week | Gorgas Course
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paul evan bunce, md @paulbuncemd.bsky.social · 04/05/2026
don't miss our latest episode of bundles (feat. brooke fraser). perfect for listening on your commute, as you relax before sleep, or during your workout. i was so excited to have brooke back that i had to re-record my opening line to dial back the intensity. link below:
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paul evan bunce, md @paulbuncemd.bsky.social · 26/04/2026
i agree fully. eccmid is my biggest fomo every year. i am appreciative of all of those who took the time to post and share throughout the conference.
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paul evan bunce, md @paulbuncemd.bsky.social · 26/04/2026
inspiring to see another potential HIV “cure”; this time led by local colleagues and mentors, sharon walmsley and mario ostrowski. #hiv #idsky #cahr
thestar.com
In a Canadian first, a Toronto man's HIV is in sustained remission. Here's what's giving scientists hope
Cancer patient’s bone marrow was replaced with donor cells that have a rare natural resistance to HIV.
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paul evan bunce, md @paulbuncemd.bsky.social · 23/04/2026
sorry, i can’t help but share this paper discussing a case of plasmablastic lymphoma in a patient with hiv (who was also impacted by the interaction between ritonavir and ICS). case report prepared by some of my colleagues (led by @yasmoayedi.bsky.social)
pmc.ncbi.nlm.nih.gov
Paying more than lip service to an oral lesion: a case of plasmablastic lymphoma
Plasmablastic lymphoma (PBL) is a variant of lymphoma originally described in the oral cavity of patients with advanced HIV. Our patient developed PBL despite well-controlled HIV and a CD4 count great...
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paul evan bunce, md @paulbuncemd.bsky.social · 20/04/2026
the latest episode of the host response is out: liars who lie. this is probably the best episode we've done yet...but you should make sure for yourself, rather than taking my word for it. #idsky #meded #goodshow
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paul evan bunce, md @paulbuncemd.bsky.social · 19/04/2026
i can't say i've ever suggested this (but have reluctantly agreed to it if recommended by others). i always thought: low yield, high risk of isolating contaminants, and no clear rationale for when to draw them (like, how long would it take bacteria to wake up after 4-6w of antibiotics?)
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Reposted by paul evan bunce, md
Bug Pharmacist // Tim Gauthier @idstewardship.bsky.social · 18/04/2026
😶‍🌫️🫥🫣 Imposter!!! Who me? #ImposterSybdrome is extremely common and something to recognize and work on if you experience it. Take it from me, I’ve totally felt this way more times than I can count!! 😆 … #ESCMIDglobal2026 … 7/n #meded #pharmed #pharmacist @escmid.bsky.social @sidpharm.bsky.social
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paul evan bunce, md @paulbuncemd.bsky.social · 18/04/2026
i enjoyed this discussion, including the antibiotic that everyone loves to hate (and hates to say the full name of).
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paul evan bunce, md @paulbuncemd.bsky.social · 17/04/2026
as a regular consumer of ID-related podcasts, i was surprised (and saddened) when i recently tried to share a podcast series with a trainee, who asked me to find the show because they had never used a podcast app before. how exactly are current trainees accessing digital learning resources? #meded
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paul evan bunce, md @paulbuncemd.bsky.social · 15/04/2026
a good piece from CBC-the current on how the r-word is creeping back into use (and why it matters)
cbc.ca
The R-word was taboo as a slur for people with disabilities. Now it's being normalized again | CBC Radio
The R-word has been considered taboo for several years, as a slur against people with intellectual and developmental disabilities. Now, the word appears to be undergoing a resurgence and normalization...
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paul evan bunce, md @paulbuncemd.bsky.social · 13/04/2026
Excellent review on diabetes-related foot infections. Reassuring that not everything in our 2013 @cmaj.ca paper has aged terribly...and the updates here are well laid out. @yasmoayedi.bsky.social www.cmaj.ca/content/198/...
cmaj.ca
A 67-year-old man with diabetes presenting with a foot ulcer
A 67-year-old man with a history of type 2 diabetes, diabetic peripheral neuropathy, and hypertension presents to the emergency department with a skin ulceration on the bottom of his great toe ([Figur...
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paul evan bunce, md @paulbuncemd.bsky.social · 09/04/2026
it's one thing to be told that you are right. but when Open Evidence comes back with: “You're absolutely correct, and I apologize for the error.” it lands a different kind of satisfaction.
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paul evan bunce, md @paulbuncemd.bsky.social · 09/04/2026
JOB OPPORTUNITY! adult immunocompromised id clinician position at uhn / university of toronto. amazing clinical work, wonderful colleagues...and (if they turn things around) a world series contenting baseball team. share widely. jobs.utoronto.ca/job/Toronto-... #idsky
jobs.utoronto.ca
Assistant or Associate Professor - Academic Infectious Diseases (Oncology ID)
Assistant or Associate Professor - Academic Infectious Diseases (Oncology ID)
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paul evan bunce, md @paulbuncemd.bsky.social · 07/04/2026
as a med student on a NSx elective, a hair fell from the fellow’s head onto the OR field. as they irrigated the area i contemplated my career options. after ~30s i said aloud “i’m not sure if he’s more upset about contaminating the field…or that he’s losing his hair.” i am now an internist.
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paul evan bunce, md @paulbuncemd.bsky.social · 06/04/2026
sometimes there are 10 possibilities: ddx, tests, treatments you don’t need to say them all at once. good consulting can be as much about timing as it is about knowledge. listen here to the latest episode of The Host Response. #idsky
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Reposted by paul evan bunce, md
IDHub @id-hub.bsky.social · 03/04/2026
Hi everyone! this is IDHub. #IDsky #idmeded #meded #infectiousDiseases A space for Infectious Diseases learning through: • cases • teaching essays • clinical tools to make clinical reasoning FUN! If you're a student, resident, or clinician, I hope this is useful! infectiousdiseasehub.com
infectiousdiseasehub.com
IDHub | Infectious Diseases Education, Cases & Clinical Tools
Free interactive clinical cases, diagnostic reasoning tools, and ID teaching essays.
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paul evan bunce, md @paulbuncemd.bsky.social · 31/03/2026
saddened to hear of the passing of Stephen Lewis. i was fortunate to have met him, and like so many, my wife and i were inspired by his words, conviction, and work. he leaves a remarkable legacy.
cbc.ca
Stephen Lewis, Canadian politician, diplomat and journalist, dead at 88 | CBC News
Former politician, diplomat and activist Stephen Lewis has died at age 88.
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paul evan bunce, md @paulbuncemd.bsky.social · 24/03/2026
i remember being taught that the appearance of CMV retinitis was like “ketchup on a pizza”
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paul evan bunce, md @paulbuncemd.bsky.social · 23/03/2026
another consideration i neglected to include: the salt load associated with various IV antibiotics. you can't cure heart failure associated edema with IV antibiotics (but you sure can make it worse).
academic.oup.com
Sodium Content of Intravenous Antibiotic Preparations
To the Editor—We read with great appreciation the recent publication by Frisbee et al [1], which examines a common and perhaps underappreciated phenomenon
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paul evan bunce, md @paulbuncemd.bsky.social · 23/03/2026
I tried to illustrate the balancing act behind choosing destination antibiotics… this is my best attempt. the point is that the decision (ideally) takes a variety of factors into account.
a multi-armed balance
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paul evan bunce, md @paulbuncemd.bsky.social · 20/03/2026
A very cool application of smartwatch data, used here to identify patients at risk of heart failure decompensation before clinical deterioration. (admission: my wife is one of the authors...but it's still fascinating) @yasmoayedi.bsky.social
thestar.com
Can your smartwatch predict heart failure before it happens? Toronto scientists say it can
Scientists from Toronto’s University Health Network developed an AI algorithm capable of accurately predicting heart failure based on smartwatch data.
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paul evan bunce, md @paulbuncemd.bsky.social · 17/03/2026
look what came in the mail today! if only they were available as audiobooks….
stack of mark crislip’s “puswhisperer” books
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paul evan bunce, md @paulbuncemd.bsky.social · 17/03/2026
is there a better day to decide to learn the irish language? here is a cbc story on those who have decided to take up the challenge.
cbc.ca
An bhfuil Gaeilge agat? Why the Irish language is ‘having a moment’ | CBC Radio
Do you speak Irish? A growing number of people are picking up Ireland’s native language, both inside the country and here in Canada.
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paul evan bunce, md @paulbuncemd.bsky.social · 15/03/2026
actually, the university of toronto is 4° south of u of washington. 🤓 but it’s a great city and community, and an amazing place to learn and practice ID. thanks for sharing the posting.
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Reposted by paul evan bunce, md
FirstcallID @firstcallid.bsky.social · 13/03/2026
Reminder: If you haven’t listened yet, check out The Host Response podcast for insights, tips, and perspectives on Infectious Diseases consultation. Perfect for anyone curious about, learning, or already practicing ID. #IDsky #meded #IDpodcast
podcasts.apple.com
The Host Response: A FirstcallID Podcast
Medicine Podcast · Updated Biweekly · The Host Response is a clinically focused, practical podcast exploring Infectious Diseases and critical topics in medical practice. Designed for learners at all s...
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paul evan bunce, md @paulbuncemd.bsky.social · 14/03/2026
well. this is exciting. u of toronto job posting for id physician with ipac role. great city. amazing colleagues. top notch hospitals, world series contending mlb team ⚾️. apply if interested. share broadly. #idsky
jobs.utoronto.ca
Assistant / Associate Professor - Academic Infection Prevention and Control Physician
Assistant / Associate Professor - Academic Infection Prevention and Control Physician
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