Acute Febrile Illness and a Splenic Mass in a 15‐Year‐Old West African Immigrant
Bibliographic record
Abstract
W ithin 24 h of arrival from West Africa, a 15-year-old boy presented to the emergency department with periumbilical abdominal pain, intermittent bloody diarrhea, vomiting and fever of three days duration.He had lived in refugee camps for over 10 years.His physical examination was remarkable for fever (40.7°C), thin body habitus (height and weight below the fifth percentile for age), scleral icterus and hepatosplenomegaly (liver palpable 2 cm below the right costal margin, span 11 cm; spleen tip 5 cm below the left costal margin).The abdomen was somewhat tender to palpation but soft, and his bowel sounds were normal.Investigations showed rare malaria parasites in the peripheral blood smear; numbers were insufficient for speciation.Stool was negative for Salmonella, Shigella, Escherichia coli 0157, Campylobacter, Aeromonas and Yersinia.Serology results for Leptospira, hepatitis A and HIV were negative.Results for hepatitis B surface antigen were positive.Cultures of blood and urine showed no growth.Serology for Epstein-Barr virus (EBV) showed the presence of immunoglobulin G to viral capsid antigen, but no immunoglobulin M was identified.A single-step Mantoux test was negative.Imaging of the liver and spleen showed a normal-looking liver, but revealed the presence of three splenic masses.Computed tomography identified two cystic lesions diagnosed as peripheral splenic infarcts, and one large noncystic mass that seemed to originate in the spleen and extend outward (Figure 1).A spleen biopsy was performed.What is the diagnosis?
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".