Case Report: Pulmonary Nocardiosis in a Patient with Chronic Obstructive Pulmonary Disease and Receiving Corticosteroid Treatment due to Nephrotic Syndrome.
Bibliographic record
Abstract
Introduction : Nocardia spp. belong to Actinomycetes family and usually found in soil. They show variation in acid fast stain. Microscobic examination reveals Gram positive filamentous bacilli. Nocardiosis, is a rare clinical situation caused by Nocardia species and takes place especially in immunosuppressed individuals. In our case report we aimed to present pulmonary nocardiosis in a patient receiving corticosteroid treatment due to nephrotic syndrome and also accompanying chronic obstructive pulmonary disease. Case Presentation : 53 year old male patient was admitted to the Chest Diseases outpatient clinic with fever, sputum and cough complaints. The patient had a previous story of nephrotic syndrome and chronic obstructive pulmonary disease and receiving corticosteroid treatment. Thorax CT image showed a 13 cm cavitary lesion at the lower lobe of the right lung, and 21 mm lesion neighboring to the other lesion. Fibrotic structure was detected on both hilus of the lung. This was evaluated as a sequela of infection. The patient underwent flexible bronchoscopy and respiratory tract specimens (bronchoalveolar lavage, bronchial lavage and sputum) were sent to the Microbiology Laboratory. The Gram stain showed filamentous Gram positive bacilli and on the fourth day of incubation Nocardia spp was reported. The patient was administered trimethoprim sulfamethoxazole treatment and recovered. Discussion : Pulmonary nocardiosis is a rare disease. The importance of this infectious pathogen has increased due to recent increase immunosuppressive treatment modalities, HIV infection, and organ transplantation. The clinical and radiological symptoms are nonspecific and because of this microbiological methods are important in diagnosis of nocardiosis. Consecutive examination of clinical material showing the typical microscopic appearance in these patients should draw the attention of the clinician to this pathogen and treatment is needed to be done accordingly.
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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) | 0.002 | 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 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.003 |
| 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".