Penicillin-Resistant Streptococcus Pneumoniae Meningitis With Subsequent Vertebral Osteomyelitis and Choledocholithiasis
Bibliographic record
Abstract
Penicillin-resistant Streptococcus pneumoniae (PRSP) meningitis is life threatening disease, and prevention and treatment of complication is important. We recently encountered two PRSP meningitis patients with undescribed complications: vertebral osteomyelitis and choledocholithiasis. Patient 1 was a 65-year-old man who presented with PRSP meningitis, disseminated intravascular coagulation (DIC), infective endocarditis, vertebral osteomyelitis, and choledocholithiasis with gallstones. Patient 2 was a 57-year-old man who presented with PRSP meningitis, DIC, acute renal failure, liver dysfunction, vertebral osteomyelitis, and choledocholithiasis with gallstones. Diffusion-weighted brain MRI of both patients revealed high-intensity areas in the posterior horns of the lateral ventricles consistent with ventriculitis. Spinal MRI revealed low-intensity on T1-weighted images and high-intensity on T2-weighted images of the lumbar vertebral bodies and intervertebral disks, consistent with vertebral osteomyelitis. Technetium-99m bone scans revealed accumulation in the lumbar vertebrae. Computed tomography (CT) scans on admission revealed no gallstones, whereas CT scans after abdominal pain or liver dysfunction revealed choledocholithiasis and gallstones. Vertebral osteomyelitis and choledocholithiasis should be noted as possible complications of PRSP meningitis. J Med Cases. 2014;5(2):108-112 doi: http://dx.doi.org/10.14740/jmc1598e
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 teacher head, 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".