Polyneuritis and Rare Sequelae of Leptospirosis Contracted While on an Urban Clean-Up Mission in Detroit : A Case Report of Weil’s Disease and Literature Review
Bibliographic record
Abstract
Leptospirosis is a common zoonosis, an infectious disease that infects both humans and animals, which is caused by spirochete bacteria from genus Leptospira . Approximately 30% of children in urban Detroit and 16% of adults in Baltimore demonstrated serologic evidence of previous leptospirosis infections. The Detroit study showed correlation between degree of rat infestation and seropositivity rates. This finding suggests rats are major vectors for human leptospirosis in mainland United States. The leptospires from infected animals survive best in fresh water, damp alkaline soil, vegetation, and mud with temperatures higher than 22 °C. Although leptospirosis is a well documented clinical condition, the sequelae of polyneuritis has not yet been reported to our knowledge. The following case is an example of such an occurrence. A 49-year-old Caucasian female presented to the emergency department with flu-like symptoms after volunteering in an urban Detroit neighborhood clean-up project. She admitted to picking up wood from stagnant water without wearing personal protective equipment. The primary differential diagnosis being Weil’s disease from leptospirosis and was proven positive with serologic testing via the Center for Disease Control. A computed tomography (CT) abdomen and pelvis demonstrated lymphadenopathy throughout the abdomen and near the spinal column. She was treated with ceftriaxone and doxycycline for 12 days but developed chronic neuralgia and polyneuritis. Leptospires are known to cause vasculitis. This patient developed polyneuritis either from direct invasion of the nerves from leptospires or compromised blood supply to the nerves. In addition to antibiotics, patients with severe cases of leptospirosis also require supportive therapy and careful management of renal, hepatic, hematologic, and central nervous system complications. If renal failure ensues, early initiation of hemodialysis or peritoneal dialysis may reduce mortality. Rapid identification of symptoms and a high clinical suspicion are paramount because early intervention can save their life. J Med Cases. 2019;10(6):183-187 doi: https://doi.org/10.14740/jmc3320
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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 teacher head, 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".