Encounters with an old foe: Childhood tuberculosis in Canada
Bibliographic record
Abstract
A previously well two-year-old child presented to the emergency department with a two-week history of fever and lethargy. Seven days before presentation, she was prescribed amoxicillin for otitis media. On examination, she appeared lethargic but conscious, responding to questions. There were no obvious focal neurological signs, although a possible neck stiffness was present. A lumbar puncture yielded clear cerebrospinal fluid (CSF) with a white blood cell count of 230 cells/μL (35% lymphocytes, 55% neutrophils and 20% monocytes), protein level of 1.4 g/L and glucose level of 2.1 mmol/L. Ceftriaxone and vancomycin were initiated for presumed partially treated bacterial meningitis. On the following day, she appeared drowsier. A computed tomography scan of the head revealed enlargement of the lateral ventricles and basal meningeal enhancement, highly suspicious for tuberculosis (TB). A small amount of CSF was retrieved from the laboratory and sent for tuberculosis culture. Isoniazid (INH), rifampin, pyrazinamide and ethambutol were commenced, together with dexamethasone. A tuberculin skin test (TST) was negative (0 mm) at 48 h. The child’s subsequent course included a ventriculoperitoneal shunt insertion for hydrocephalus. The original small CSF volume did not grow any organisms; however, the larger volume obtained at the time of shunt placement grew Mycobacterium tuberculosis, resistant to INH but sensitive to other first-line agents. INH was discontinued, and levofloxacin and cycloserine were added to the regimen. The child developed seizures on the 25th day of therapy, with magnetic resonance imaging evidence of a right-sided stroke with subsequent left hemiparesis and global delay.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".