Cytomegalovirus encephalitis radiographically mimicking lateral medullary stroke
Bibliographic record
Abstract
Cytomegalovirus (CMV) is a double-stranded DNA virus from the herpes virus family.Disseminated or focal end-organ disease typically occurs in immunocompromised individuals, often in the setting of advanced HIV or organ transplantation.Neurologic manifestations include focal encephalitis, meningitis, ventriculoencephalitis, and polyradiculitis.After the advent of highly active antiretroviral therapy (HAART), the incidence of CMV disease has decreased by as much as 80%. 1 This decrease largely predates the widespread adoption of MRI into routine patient care.As a result, our understanding of CMV and the spectrum in which it radiographically manifests is limited. 2 We report a case of CMV ventriculoencephalitis and myelitis radiographically mimicking lateral medullary stroke in a patient with advanced HIV.Case report A 50-year-old HIV-positive man was admitted for a 4-day history of diarrhea.He was referred to neurology for left-sided sensorimotor deficits, and an MRI reported as demonstrating a lateral medullary infarct (figure 1A).He was diagnosed with HIV 14 years ago and was well controlled on HAART up until 4 years ago, at which time he stopped all treatment because of a refusal to accept his diagnosis.His CD4 + count reached a nadir of 10 cells/mm 3 , and the peak viral load was 263,132 copies/mL.Seven months before presentation, he was admitted with disseminated CMV infection manifesting as CMV colitis and retinitis.At that time, he was treated with IV ganciclovir and discharged on prolonged suppressive therapy with oral valganciclovir.Collateral history revealed that he began having slowly progressive left hemibody sensorimotor symptoms 11 months before his current admission.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".