Unusual Marine Pathogens Causing Cellulitis and Bacteremia in Hemodialysis Patients: Report of Two Cases and Review of the Literature
Bibliographic record
Abstract
Cellulitis in immunocompetent hosts is usually caused by skin organisms and responds to oral antibiotics. In immunocompromised hosts, such as end-stage renal disease (ESRD) patients, unusual organisms with unpredictable pathogenicity can cause infections. We present two cases with isolates that are usually encountered in coastal waters. The first case describes a 71-year-old African-American ESRD patient who presented with bacteremia secondary to a wound infection after exposure to flood waters in a tropical storm. The second case describes a 70-year-old Caucasian male ESRD patient who developed septic shock after a trivial wound inflicted while on a shrimp boat. Both patients were successfully treated with appropriate antibiotics and supportive measures. The infective agents in both cases belong to the halophilic Vibrio species. The causative agent of cellulitis and bacteremia in the first hemodialysis patient was identified as Vibrio alginolyticus, a non-lactose-fermenting gram-negative bacillus that is rarely isolated from blood. The second patient presented with septic shock owing to Vibrio vulnificus, which is a lactose-fermenting bacillus known to produce severe localized or systemic illness. In both cases, the common features were ESRD-related immunocompromised state and exposure to marine environments. These two cases of life-threatening cellulitis and bacteremia are presented as examples of environmental pathogens common to a marine environment in coastal areas and the imperative need of rapid identification and prompt initiation of treatment in immunocompromised hosts.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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) | 0.000 | 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".