Erythema Induratum and Tuberculosis-Associated Ocular Inflammation in Low Tuberculosis Incidence Setting: 11-Year Retrospective Case Review With Prospective Clinical Follow-Up in Alberta, Canada
Bibliographic record
Abstract
Background. Erythema induratum (EI)—nodular vasculitis associated with Mycobacterium tuberculosis (TB)—and tuberculosis-associated ocular inflammation (TB-AOI) represent uncommon manifestations of TB in low incidence countries. Both entities are diagnosed indirectly and neither has standardized therapy. Methods. Retrospective review of EI and TB-AOI cases managed in a provincial TB program between 1 January 2004 and 31 December 2014. Prospective phone-based follow-up pursued for those who received anti-tuberculosis therapy (ATT). TB-AOI diagnosis was based on referring ophthalmologist's assessment and positive TB testing (IGRA/TST). EI cases were referred following dermatologist assessment and met clinical or pathologic criteria along with positive TB testing. Results. Twenty-two EI and 21 TB-AOI cases were managed over the study period, 10 and 11, respectively, were reached for phone-based follow-up. The majority of EI and TB-AOI cases were female and immigrated from TB high-burden countries. Mean ages at time of diagnosis were 44.3 and 39 years (IQR 8.25 and 18) for EI and TB-AOI cases, respectively. Mean duration of symptoms prior to diagnosis were 3.1 and 1.8 years (IQR 2 and 2.1) for EI and TB-AOI cases, respectively. Amongst 17 EI cases that underwent biopsy, granulomatous inflammation was the most common finding (88%) followed by panniculitis (59%), necrobiosis (53%) and vasculitis (47%). ATT was initiated in 41 (95%) cases with 36 (88%) completing therapy. 14 different ATT regimes were used for a mean duration of 5.8 months (range 1–9). ATT related side effects occurred in 52% of EI and 35% of TB-AOI cases of which 18% and 19%, respectively, resulted in therapy cessation. Clinical resolution was documented in 70% of EI cases at a mean clinical follow-up of 7.3 months (range 0–48); however, only 50% of EI and 18% of TB-AOI patients reported sustained resolution of symptoms on phone-based follow-up at mean post treatment periods of 4.5 and 3.8 years (IQR 3.8 and 4), respectively. Conclusion. In this cohort, EI and TB-AOI represented uncommon presentations receiving highly variable therapy with high rates of ATT side effects. Fewer than half of patients contacted on follow-up reported durable resolution of symptoms. Disclosures. All authors: No reported disclosures.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| 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".