The Long CoN(S): A Case of Staphylococcus lugdunensis Endocarditis With Cerebral and Coronary Embolism
Bibliographic record
Abstract
Staphylococcus lugdunensis is a coagulase-negative staphylococcus, which in humans can cause virulent infections frequently attributable to Staphylococcus aureus including superficial skin/soft tissue infections, infective endocarditis, osteomyelitis and endophthalmitis. A 61-year-old male with history of recent fixation of C1-C2 neck fracture, presented with sudden onset of right-sided weakness and fever. Examination revealed dense hemiplegia with UMN facial palsy of right side, and a pan-systolic murmur in the mitral area, radiating to the axilla. He had an elevated troponin-I of 18.8 ng/mL with right bundle branch block on EKG. Echocardiogram revealed mobile vegetation on the anterior leaflet of the mitral valve with ejection fraction of 55% and no regional wall motion abnormality. He continued to have persistent high-grade fevers in spite of appropriate antibiotic therapy and blood cultures were persistently positive for S. lugdunensis for 5 days. He developed weakness of his left side after 2 weeks of hospital admission and MRA revealed left carotid dissection and complete occlusion of the right middle cerebral artery distal to the M1 segment which was embolic in nature. The frequency of S. lugdunensis infection is underappreciated and biofilm formation plays a major role in the pathogenesis. This is the first reported case of S. lugdunensis endocarditis complicated by NSTEMI from coronary embolism and simultaneous stroke from cerebral embolism. Due to the early, frequent and fatal complications from S. lugdunensis bacteremia, we might have to consider early surgical intervention in the absence of class I or IIa recommendation. J Med Cases. 2014;5(10):535-537 doi: http://dx.doi.org/10.14740/jmc1903w
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| 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".