Community-acquired invasive liver abscess syndrome caused by a K1 serotype Klebsiella pneumoniae isolate in Brazil: a case report of hypervirulent ST23
Bibliographic record
Abstract
Hypervirulent Klebsiella pneumoniae (hvKP) strains can cause invasive liver abscess syndrome, which is characterised by liver abscess with extrahepatic complications including central nervous system involvement, necrotising fasciitis or endophthalmitis hvKP was first reported in Taiwan in 1985 and, since then, infections caused by hvKP have been described in several parts of the world, with many cases reported in Southeast Asia In the Americas, invasive liver abscess syndrome has been reported in the United States of America, Canada and Argentina However, this strain has not been previously reported in Brazil. Recently, a 57-year-old woman with diabetes mellitus was admitted to the emergency department with a history of fever, nausea, vomiting and mental confusion for five days. On the day of admission, she was comatose, icteric and had a poor general appearance. Her temperature was 37.8C and her blood pressure, pulse and respiratory rate were 110/60 mmHg, 96 beats/min and 48 breaths/min, respectively. Respiratory and cardiovascular auscultations were normal; however, a neurological examination revealed neck rigidity. Bacterial meningitis was suspected and ceftriaxone 2 g IV q12 h was empirically prescribed after performing a diagnostic lumbar puncture. Her cerebrospinal fluid (CSF) was xanthochromic and showed glucose 0.0 mg/dL, protein 485 mg/dL and 8,640 cells/mm 3 (8,121 neutrophils/ mm 3 and 259 lymphocytes/mm 3 ). Direct examination
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.003 |
| 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; both teacher heads agree on what is shown here.
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".