MRI Findings in an Immunocompromised Boy with CNS Fungal Infection
Bibliographic record
Abstract
An immunosuppressed 11-year-old with relapsed T-cell leukemia presented with subacute onset fever, headache and a "heavy" right hand.Neurologic examination revealed right-sided hemiparesis and hypesthesia.Magnetic resonance imaging (MRI) 24 hours after symptom onset disclosed lesions involving the right cerebellar hemisphere, left putamen, and cortex in the right frontal lobe and left frontoparietal region (Figure 1).The lesions were gyriform, T1 hypointense, non-enhancing, and T2 hyperintense, with blooming of the larger lesions on the gradient echo sequence consistent with hemorrhage.Interestingly, on fluid attenuation inversion recovery (FLAIR) imaging, the lesions were predominantly isointense with only a small peripheral rim of increased signal.The lesions demonstrated increased signal on the diffusion weighted sequences (DWI) and decreased signal on the apparent diffusion coefficient (ADC) map in keeping with restricted diffusion.There was minimal edema and mass effect.Cerebrospinal fluid (CSF) showed normal glucose, protein, red and white blood cell counts.Flow cytometry did not reveal leukemic cells.There was no serum or CSF evidence of acid-fast bacilli, toxoplasma, enterovirus or herpes simplex virus.Echocardiogram was normal.Biopsy of a lung infiltrate was non-diagnostic.The clinical course fluctuated, with worsening hemiparesis, expressive language difficulties and depressed level of consciousness, which responded only temporarily to
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 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 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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".