<i>Haemophilus influenzae</i> type b necrotizing fasciitis in an adult with common variable immunodeficiency
Bibliographic record
Abstract
Necrotizing fasciitis of an extremity due to Haemophilus influenzae is exceptionally uncommon in adults, particularly since the advent of widespread vaccination with conjugated H. influenzae type b (Hib). We report a previously vaccinated, 39-year-old male with a history of common variable immunodeficiency (CVID), poorly compliant with intravenous immunoglobulin (IVIG) therapy, who required emergent treatment for left leg necrotizing fasciitis. The patient was initially treated with piperacillin-tazobactam, vancomycin, and clindamycin, in tandem with surgical debridement and wash-out. The patient responded well and completed a 2-week course of ceftriaxone following blood culture results that demonstrated beta-lactamase–positive Hib. This is the fifth documented case of necrotizing fasciitis caused by H. influenzae, and the first affecting an adult with prior Hib vaccination. This case highlights the importance of IVIG compliance for CVID patients and advocates considering encapsulated organisms as part of the differential diagnosis for severe skin and soft tissue infections in this patient population.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".