A rare case of pulmonary <i>Mycobacterium szulgai</i> treated with combined drug therapy and bilateral surgical lung resection
Bibliographic record
Abstract
Mycobacterium szulgai is an uncommonly isolated non-tuberculous mycobacterium (NTM) of clinical and pathological significance that is usually managed with antimycobacterial therapy alone. We describe an unusual case in a 52-year-old woman with mild dyspnea, productive cough and small-volume hemoptysis. Chest imaging demonstrated large bilateral apical lung cavities with positive bronchial washings for M. szulgai. Despite medical treatment the patient's symptoms did not resolve and repeat imaging revealed enlarging apical lung cavities. She was treated with bilateral upper lung resections in addition to continued antimicrobial therapy, with full resolution of symptoms and cavitary lesions one year after surgery. Our report is the first to show that bilateral lung resection, in addition to medical treatment, can be used successfully to eradicate bilateral cavitary pulmonary disease due to M. szulgai.RÉSUMÉMycobacterium szulgai est une mycobactérie non tuberculeuse (MNT) d'importance clinique et pathologique exceptionnellement isolée qui est habituellement prise en charge à l'aide d'un traitement antimycobactérien seul. Nous décrivons un cas inhabituel observé chez une femme de 52 ans souffrant de dyspnée légère, d'une toux productive et d'une hémoptysie de faible abondance. Les examens d'imagerie thoracique ont démontré l'existence de grandes cavités pulmonaires apicales bilatérales et des lavages bronchoalvéolaires ont révélé la présence de M. szulgai. Malgré le traitement médical, les symptômes de la patiente ne se sont pas résorbés et de nouveaux examens par imagerie ont révélé un agrandissement des cavités pulmonaires apicales. Elle a été traitée par résections du poumon supérieur, tout en poursuivant la thérapie antimicrobienne. Les symptômes et les lésions cavitaires se sont entièrement résorbés un an après la chirurgie. Notre rapport est le premier à démontrer que la résection pulmonaire bilatérale – en plus du traitement médical – peut être utilisée avec succès pour éradiquer la maladie pulmonaire cavitaire bilatérale attribuable à M. szulgai.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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 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".