AN UNUSUAL CASE OF STREPTOCOCCUS BOVIS MENINGITIS IN A HEALTHY 9 WEEK OLD INFANT
Bibliographic record
Abstract
Objectives: Streptococcus bovis is a rare cause of meningitis in children. It usually presents in the neonatal period and the outcome of these children is not well known. Therefore we sought to 1) To highlight a rare case of Streptococcus bovis meningitis and septicaemia in an otherwise healthy 9 week old infant. 2) To discuss potential risk factors and long-term follow-up in an infant with S. bovis meningitis. Methods: Case Report. Results: This 9- week term male infant presented with fever and lethargy for one day. Blood and CSF cultures were positive for Streptococcus bovis. Urine and stool cultures were negative. The infant was empirically treated with ampicillin and cefotaxime until sensitivity results were obtained, then continued on intravenous ampicillin monotherapy for 14 days to which he responded clinically. Early clinical findings included irritability, nuchal rigidity and long tract signs with decreased truncal tone. His clinical exam normalized by the end of therapy. There were no clinical seizures. EEG and head MRI were normal. Investigations to exclude factors predisposing to this unusual organism were completed. Echocardiography ruled out endocarditis. Abdominal ultrasound was unremarkable. Plain films of the spine excluded abnormalities such as hemivertebrae and blocked vertebrae associated with intradural neurenteric cysts. Conclusion: We report the first case of S. bovis meningitis in an infant outside the neonatal period. This is the oldest infant reported with this pathogen and only the eighth documented case in a child less than 1 year of age. Congenital abnormalities that may predispose this infant to S. bovis meningitis were excluded. This case illustrates that S. bovis can cause meningitis in infants outside of the neonatal period and must be differentiated from other species of streptococcus to ensure appropriate investigations and therapy are instituted. We will include at time of presentation the follow-up audiologic investigations and neurodevelopmental status.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 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) | 0.002 | 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".