Disseminated Mycobacterium Sepsis with Bone Marrow, Liver, and Lung Involvement Following Intravesical Bacillus Calmette-Guerin (BCG) Therapy
Bibliographic record
Abstract
Introduction Bacillus Calmette-Guerin (BCG) therapy is first-line therapy for high grade non-muscle invasive bladder cancer (NMIBC). Case Presentation A 54-year-old male presented with fevers, rigors, and hematuria one week following intravesical BCG administration for treatment of NMIBC. He developed fever, pancytopenia, elevated liver enzymes and pulmonary infiltrates with the progression of symptoms despite broad-spectrum antimicrobial therapy. A bone marrow biopsy showed granulomatous infiltration; cultures of urine demonstrated the growth of Mycobacterium bovis. A diagnosis of disseminated BCG infection secondary to intravesical administration was made; rifampin, isoniazid, ethambutol, and high dose prednisone were initiated. Conclusion Adverse events associated with BCG administration have been attributed to both the primary mycobacterium infection and to hypersensitivity reactions. Timely collection of histopathology can lead to early treatment of disseminated BCG with good outcomes. Internists should have a high index of suspicion for patients presenting with organ dysfunction with an immediate or remote history of intravesical BCG administration.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".