Disseminated herpes simplex virus 2 (HSV-2) encephalitis in a liver transplant recipient: Potential implications for liver transplant programs
Bibliographic record
Abstract
Herpes simplex virus type 2 (HSV-2) is a rare cause of herpes encephalitis. We report a case of severe right limbic encephalitis presenting as an altered level of consciousness in a post-liver transplant adult man. HSV-2 was identified by polymerase chain reaction in the cerebrospinal fluid (CSF). Concurrent active perineal skin eruptions were positive for HSV-2, confirming the theory of disseminated HSV-2 from genitals to brain. Intravenous acyclovir was given for 3 weeks. Although the outcome was an improved level of consciousness, the patient was left with significant residual neurological morbidity. Our experience emphasizes the importance of HSV prophylaxis in those with positive serostatus pre-transplant, and not on cytomegalovirus (CMV) prophylaxis in the immediate post-transplant period. We also recommend stringent pre-transplant assessment, including specific and direct questioning of candidates regarding a history of sexually transmitted infections (STIs), a determination of HSV serostatus, and the examination and testing of any suspicious lesions.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".