Monkeypox-associated proctitis and rectal wall perforation
Bibliographic record
Abstract
Monkeypox is a viral zoonotic infection which has rapidly increased in incidence and spread globally since May 2022. There have been reports of rectal complications of monkeypox but so far these are not well not understood. Here, we describe a case of rectal pain in HIV-positive man with confirmed monkeypox. MRI on day 5 of hospital admission revealed proctitis with localised perforation. The patient was treated with tecovirimat, antibiotics, analgesia and laxatives and improved without requiring surgical intervention. All patients presenting with new rectal symptoms and deemed high-risk for monkeypox should be isolated and screened for the disease, and appropriate personal protective equipment should be worn by healthcare professionals caring for them. Clinicians should have a low threshold for cross-sectional imaging in patients with confirmed or suspected monkeypox who experience persistent and severe rectal symptoms or who become systemically unwell to investigate for complications such as perforation and abscess formation. The vast majority of monkeypox cases do not require antibiotics and their use should be reserved for patients who show signs of secondary bacterial infection or sepsis.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".