Aortic Insufficiency Secondary to Enterococcus faecalis Endocarditis in an HIV-Positive Patient
Bibliographic record
Abstract
Enterococcus faecalis is the third most common cause of endocarditis. HIV infection is an independent risk factor for the development of endocarditis when the cell count is below 200 cells/mL and without retroviral therapy. A 49-year-old Caucasian male, with HIV infection in triple therapy, no detectable viral counts and CD4 cell count over 1,000 cells/mL, is admitted to the hospital with dyspnea and an acute bacterial infection. On the physical exam, he presented tachycardia, systolic murmur I/IV, bilateral basilar rales, hypotension and fever. The echocardiogram showed an aortic valve vegetation, with prolapse of one of the leaflets, severe aortic insufficiency, mild mitral regurgitation and severe pulmonary hypertension. CXR with bilateral infiltrations and CT scan showed in addition mediastinal lymphadenopathy. He underwent an emergency cardiac surgery replacing his aortic valve for a prosthetic, and the culture of the vegetation was positive for E. faecalis . Treatment with vancomicin and gentamicin was initiated. Infective endocarditis by E. faecalis in this patient had probably a non-HIV-related etiology because of the adequate antiretroviral therapy that he was having. Most probably the rectal abscess could have been the source of the sepsis. J Med Cases. 2015;6(2):51-54 doi: http://dx.doi.org/10.14740/jmc1946w
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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 | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".