Endocarditis in Adult-onset Still Disease: A Case Report and Literature Review
Bibliographic record
Abstract
To the Editor: Adult-onset Still disease (AOSD) is one of the most common autoinflammatory conditions responsible for fevers of unknown origin. AOSD is characterized by prolonged spiking fever, arthritis, evanescent rash, leukocytosis, and multiorgan involvement. Endocarditis, especially the right-sided type, is extremely rare in AOSD. Here we report a case of noninfective endocarditis in the tricuspid valve caused by AOSD. An 18-year-old man who had a high fever and evanescent rashes in the chest for 3 weeks was admitted to our hospital. His fever was typically > 39°C and was accompanied by intermittent sore throat, polyarthralgia, and abdominal pain. There were 1 or 2 spiking fevers in a day (in the afternoon or evening), which showed good response only to dexamethasone. He had no history of other diseases and had not stayed in any epidemic areas. He stated that he did not have any drug addiction or allergies. In physical examinations, he had tenderness in his shoulder and knee joints, no enlargement of lymph nodes, and had abdominal rigidity. Vital signs revealed fever and … Address correspondence to Dr. X. Zhang, Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University, No. 3 East QingChun Road, Hangzhou, China. E-mail: 3408234{at}zju.edu.cn.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".