Streptococcus Intermedius Spondylodiscitis: An Unusual Presentation of Acute Back Pain in an Elderly Gentleman With Parkinson’s Disease
Bibliographic record
Abstract
Back pain is a common problem affecting approximately one-third of the UK adult population each year with the etiology in older people commonly attributed to osteoporosis and spondylosis. Uncommon causes, such as spondylodiscitis, can potentially cause significant complications, therefore early diagnosis and management are imperative. We present an unusual case of back pain in an elderly gentleman with Parkinson’s disease (PD) attributed to Streptococcus intermedius spondylodiscitis. A 73-year-old gentleman presented with non-specific chest and abdominal pain. Inflammatory markers were elevated, consolidation demonstrated on chest X-ray, and antibiotics were commenced. Patient suffers from PD managed with selegiline , s talevo , and a self-administered a pomorphine subcutaneous pump. He developed a constant severe lower back pain without neurological deficit. Streptococcus intermedius was identified on blood culture and common sources were excluded. Magnetic resonance imaging and minimal-preparation computed tomography (CT) confirmed intervertebral spondylodiscitis. A conservative approach with combination antibiotics and rehabilitation was undertaken and the patient returned to his previous functional level. We report an unusual case of spondylodiscitis in an elderly gentleman with PD. The initial presentation of radicular pain, unusual causative agent isolated, and the likely source of infection from the a pomorphine pump highlight the importance of clinical suspicion, early diagnosis and management of patients with spondylodiscitis. J Med Cases • 2013;4(12):789-791 doi: http://dx.doi.org/10.4021/jmc1550w
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".