<i>Pleurostomophora richardsiae</i> – An Insidious Fungus Presenting in a Man 44 Years After Initial Inoculation: A Case Report and Review of the Literature
Bibliographic record
Abstract
A 54-year-old man from Guyana presented with a painful, nonery- thematous, subcutaneous nodule on his right patella at the site of a remote injury.The patient fell while climbing a coconut tree at 10 years of age, 44 years before presentation.The fall caused him to land on the stump of a 'black sage tree' injuring his right patella.Multiple small splinters from the stump penetrated his skin over and around his patella, which were removed shortly after the initial injury.The patient reported a significant amount of purulent discharge that eventually subsided.He was never treated with antibiotics.For approximately the next 40 years, the patient reported a history of knee swelling that dramatically increased in recent years.He reported no recent trauma.He experienced no fever, chills, sweats or recent weight loss.The patient was a nonsmoker, did not drink alcohol and had no history of injection drug use.On examination, he was afebrile and looked well.There was no lymphadenopathy.There was a 4 cm × 4 cm nonerythematous, indurated nodule on the anterior aspect of the right patella.There was no joint effusion; however, there was a prepatellar bursitis.The lesion was not adherent to the patella and moved freely.Complete blood count, glucose level, renal function, hepatic transaminases and serum protein electrophoresis were all normal.He was HIV seronegative.A radiograph of the right knee did not demonstrate any foreign body or bone destruction.The prepatellar fluid was aspirated, producing thick fluid, tan-red in colour.Cytological analysis of the fluid showed histiocytes with inflammatory cells.A Gram stain of the fluid did not demonstrate any pus cells or bacteria.Routine aerobic and anaerobic bacterial cultures were negative for bacterial growth.Mycobacterial smears and cultures were also negative.A direct mycology smear using calcofluor white was negative, but two colonies of a filamentous fungus were noted both on the routine sheep blood agar and chocolate agar culture plates after four days of incubation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".