Conservative Management and Organ Preservation in a Unique Case of Group A Streptococcus Infection Causing Splenomegaly, Splenic Infarction, and Non-Traumatic Rupture Leading to Intra-Abdominal Abscess and Pleural Empyema
Bibliographic record
Abstract
Non-traumatic splenic rupture (NSR) is a clinical oddity. Most splenic ruptures occur due to trauma. Splenic abscess formation is also a rare occurrence. Majority of splenic infections are secondary to splenic infarction or infection that originates external to the spleen. We present a unique case of a 40-year-old previously healthy woman who presented with splenomegaly, splenic infection, infarction, non-traumatic rupture, abscess formation, and pleural empyema positive for group A Streptococcus pyogenes . She initially presented to the emergency department complaining of worsening epigastric abdominal pain, fever, chills, and progressive shortness of breath. A computed tomography (CT) scan of the chest, abdomen, and pelvis revealed hepatomegaly and splenomegaly with infarcts and lacerations. Elaborate hematologic, thromboembolic, and oncological workup were essentially negative. She was managed non-operatively with a long course of antibiotics and pleural and intra-abdominal drainage. Clin Infect Immun. 2019;4(2):31-36 doi: https://doi.org/10.14740/cii80
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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) | 0.001 | 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) | 0.002 | 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".