Cryptococcoma in Idiopathic CD4 Lymphopenia
Bibliographic record
Abstract
Idiopathic CD4 lymphopenia is a rare immune disorder that renders patients vulnerable to unusual infections. A 25-year-old female had been diagnosed with idiopathic CD4 lymphopenia (CD4 count of 50/uL) at age 14 after pulmonary infection with atypical mycobacterium, but had since been asymptomatic on Trimethoprim/Sulfamethoxazole prophylaxis. She presented now with 5 weeks of headache, vomiting, diplopia, and vertigo. This had been diagnosed as benign positional vertigo. However, neuro-ophthalmologic exam revealed gaze-evoked nystagmus, impaired smooth pursuit, a left hypertropic skew deviation, left sensorineural hearing loss, gait ataxia and left limb dysmetria. MRI brain showed a 15 mm extra-axial enhancing mass at the left cerebellopontine angle, and chest CT showed pulmonary lesions. CSF Cryptococcal antigen was highly positive (> 1:1024) and CSF culture grew Cryptococcus neoformans variety grubii. She was treated with amphotericin B 175 mg daily and 5-Flucytosine 1000 mg QID for 4 weeks, followed by Fluconazole 400 mg daily, and made an excellent recovery. Cryptococcal infection usually presents as a meningitis, but can occasionally present as a mass lesion. Cryptococcal infection is one of the most common complications in idiopathic CD4 lymphopenia. This case illustrates the importance of neurologic signs in correctly localizing the lesion and the need for high suspicion of serious pathology in patients with rare immune disorders.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".