In this episode of The Host Response, Dr Paul Bunce reflectson the lasting influence of Mark Crislip, known to many as the Puswhisperer, and his infectious diseases podcasts Persiflager’s Infectious Diseases Puscast and Gobbet o’ Pus.

From 2007 to 2021, the Puscast offered a biweekly review ofthe infectious diseases literature, combining sharp critical appraisal with practical clinical insight. For many trainees and practicing ID physicians, it became essential listening and a way to stay current before infectious diseases had much presence on social media.

Gobbet o’ Pus delivered more than 1400 short clinical pearlscovering Staphylococcus aureus bacteremia, candidemia, HSV detected in bronchoalveolar lavage specimens, immunodeficiency screening in invasive pneumococcal disease, and much more. Many of these lessons remain deeply relevant despite evolving guidelines.

In this tribute episode, we revisit several classic Gobbetsand reflect on recurring themes that shaped a generation of infectious diseases clinicians, including the limits of anecdote, the perils of spiraling empiricism in antibiotic therapy, and the intellectual breadth required of ID consultants.

If you trained in infectious diseases in the late 2000s or2010s, this episode may feel familiar. If you did not, consider it an introduction to one of the foundational voices in digital ID education.

The Host Response is a FirstCallID podcast focused onclinical reasoning and practical infectious diseases teaching.

In this episode of The Host Response, Dr. Paul Bunce explores a deceptively simple but powerful skill in medicine: using the insights of your colleagues when facing challenging cases. Drawing on a real life blastomycosis case and strategies for spotting blind spots in your own reasoning, Paul shows how mentally asking “WWJD?” what would your experienced peers do can guide decisions, clarify uncertainty, and improve patient care.

This episode is ideal for infectious diseases physicians, trainees, and any clinician navigating complex cases. It highlights the value of humility, collaboration, and integrating diverse expertise into your thinking.

Coomes EA, Bunce PE. Sickle Cough: A Case of Nonresolving Pneumonia. Am J Med. 2018 Sep;131(9):e369-e370.

https://pubmed.ncbi.nlm.nih.gov/29660349/

In infectious diseases, reading the radiology report is not enough. In this episode, Dr. Paul Bunce explains why looking at imaging yourself is a core part of a thoughtful ID consultation.

From abscesses that sound impressive on paper but are not actually drainable, to pleural effusions, pneumonias, postoperative collections, and liver abscesses, this episode explores how reviewing the images changes clinical decisions. We discuss how imaging helps assess severity, feasibility of intervention, trajectory of response, and realistic expectations for both procedures and antibiotic duration.

This episode is for trainees and clinicians who want to sharpen their consult skills, avoid overconfident recommendations, and understand why experienced ID physicians insist on opening the images rather than relying solely on the report.

Dr. Paul Bunce and Dr. Brooke Fraser (newly minted Adult IDspecialist), bring you the third episode in our “Bundles” series with fourquick-hitting topics blending infectious diseases and beyond.

Resources & Highlights:

• Sunnybrook Antimicrobial Stewardship AppA practical, user-friendly tool for antibiotic guidance, dosing, and special situations like pregnancy.
• Online TST/IGRA Interpreter (TSTin3D). Estimates individualized TB progression risk and helps guide preventive therapy decisions. https://www.tstin3d.com/
• Updated IDSA UTI Guidelines (2025)New criteria for complicated vs. uncomplicated UTIs and clear recommendations on empiric and step down antibiotic therapy.
• IV Iron During Infection – ASH 2025 Abstract: Challenging the dogma: IV iron may be safe and beneficial even during acute bacterial infections.

Safe Space:

• Antibiotic-associated rash in infectious mononucleosis: immune-mediated and usually transient.
• Kingella kingae as a stealth cause of pediatric bone and joint infections. https://communicable.transistor.fm/episodes/communicable-e44-top clinical-microbiology-papers-in-2025 https://journals.asm.org/doi/10.1128/jcm.00986-25

Why do some patients worsen after starting the right antibiotics?

In this episode, Dr. Paul Bunce breaks down the post antibiotic inflammatory crash, why it happens, how to recognize it, and how to manage deterioration without reflexively broadening therapy.

A must listen for trainees facing the unnerving moment when treatment appears to make things worse.

In this episode of The Host Response, infectious diseases physician Paul Bunce reflects on how clinical judgment, priorities, and perspective evolve over time in practice.

Drawing on advice he shared early in his career (and revisiting it a decade later) this episode contrasts three tips for new ID doctors then with three updated lessons now, highlighting what has changed and what has stayed the same.

Topics include:

• Early career reputation and professional identity

• Antibiotic overuse and unintended patient harm

• Clinical pacing, sustainability, and burnout prevention

• Collegial support, trusted second opinions, and work “buddies”

• Why some truths in infectious diseases never really change

This episode is not a checklist or a how-to guide. It’s a reflection on approaching competence, ongoing learning, and the realities of long-term practice in infectious diseases and internal medicine.

Relevant for infectious diseases physicians, fellows, residents, internists, hospitalists, and trainees thinking about early career development, clinical reasoning, and sustainable practice.

In this episode of The Host Response, Infectious Diseases specialist Paul Bunce flips the usual conversation about “favourite ID consults” on its head.

Instead of rare pathogens and diagnostic fireworks, this episode focuses on the consults many ID clinicians quietly dread and why they may be some of the most meaningful work we do.

Topics include:

• Recurrent urinary tract infections and lower urinary tract symptoms

• Recurrent Staphylococcus aureus skin and soft tissue infections

• Persistent symptoms after treated Lyme disease

• Post–IV antibiotic follow-up and PICC line visits

• Refractory Helicobacter pylori infection

These are the consults that test patience, communication skills, and clinical judgment, often with no dramatic “save.” But they’re also opportunities to reduce harm, restore perspective, teach trainees, and meaningfully improve quality of life.

This episode is about reframing so-called “nuisance consults,” resisting the urge to defer or dismiss them, and recognizing where Infectious Diseases expertise adds value even when we aren’t prescribing antibiotics.

Ideal for:Infectious Diseases physicians, Fellows, Residents, Internists, Hospitalists, and trainees interested in the real work of ID consultation.

More ID teaching resources and short-form educational videos are available at FirstCallID.ca.

The Bundle 2.0 is here. In this episode of The Host Response, Dr. Paul Bunce and returning guest Dr. Brooke Fraser take another rapid-fire tour through what’s catching their attention across infectious diseases and adjacent domains: teaching tools worth knowing, papers that may shift practice, ideas from outside ID that still matter, and the small-but-important clinical pearls that surface in everyday work.

We cover:

• ID teaching tools worth your time, including Open Evidence and the Breakpoints podcast.

  www.openevidence.com

  https://breakpoints-sidp.org/episodes/

• Literature we’re thinking about, from cardiac complications of Mycoplasma pneumoniae to whether immunosuppression really needs to be held during infection.

  https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaf453/8244960

  https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaf442/8232734?redirectedFrom=fulltext&login=false#google_vignette

• Reflections from beyond medicine, including writing on polarization in healthcare and why “giving” may actually be a strategic advantage.

  https://macleans.ca/society/health/a-doctors-plea-for-civil-discourse/

  
  

• Safe-space learning, featuring fluoroquinolone-associated tendinopathy and a practical look at divalent-cation interactions with dolutegravir and common antibiotics.

  https://www.mdpi.com/1424-8247/18/2/184

  https://accp1.onlinelibrary.wiley.com/doi/10.1002/jcph.439

If you’re an ID clinician, general internist, resident, or simply ID-adjacent and curious, this one is packed with things you can actually use.

This episode explores the infectious diseases approach to rashes, skin lesions, and cutaneous manifestations of systemic illness. We review key diagnostic clues, high-yield dermatologic findings in infectious diseases, and life-threatening rash presentations clinicians must recognize early. Topics include erythema nodosum, Sweet syndrome, nodular lymphangitis, pyoderma gangrenosum, disseminated viral exanthems, necrotizing fasciitis, purpura fulminans, and ecthyma gangrenosum. Practical guidance is provided on describing skin lesions, identifying dermatologic signs of immunosuppression or acute infection, and differentiating benign from high-risk presentations in adult patients.

In this episode of The Host Response, Dr. Paul Bunce (Infectious Diseases specialist and clinician teacher) reflects on his complicated relationship with academic writing. From a fellowship project that refused to die to his mother’s psychic prediction that he’d one day be “published,” this episode explores what makes a medical paper worth writing.

He shares his personal criteria for taking on a writing project: lessons about mentorship, practicality, curiosity, and the occasional clever title that never made it past peer review.

Whether you’re a trainee, educator, or reluctant author, this episode offers a candid, funny, and ultimately hopeful take on publication in medicine, and how writing can still matter, even if it’s not your main metric of success.