S3571 A Rare Case of Raoultella ornithinolytica Bacterial Infection in Liver Cirrhosis Patient
Bibliographic record
Abstract
Introduction: Infection with Raoultella ornitholytica is rare and this Gram-negative, oxidase-negative, non-motile, capsulated facultative anaerobic bacillus of the Enterobacteriacae family is generally found in aquatic environments, fish, and insects. Raoultella ornitholytica occurs mainly in patients with underlying malignancies or chronic diseases, trauma, nosocomial infection, and invasive procedures and is a risk factor for a poor outcome. The bacterium was originally named Klebsiella ornitholytica but was reclassified as Raoultella ornitholytica. Case Description/Methods: 68 y.o. man with a known history of alcoholic liver cirrhosis with grade 2 esophageal varices, CAD status post-PCI, essential hypertension, hyperlipidemia, and GERD presented to the emergency room after being advised by an outside hospital following positive blood cultures. He had recently visited Canada, where he presented to a local emergency room with chills and confusion, was diagnosed with a urinary tract infection, and was subsequently treated with antibiotics. He denied any seafood ingestion or heavy alcohol intake at the time (Figure 1). Upon presentation, he was noted to have significant worsening of ascites and confusion. Initial vitals and labs met septic criteria. CT abdomen and pelvis revealed liver cirrhosis, esophageal varices, and significant ascites. Paracentesis performed was indicative of SBP. The ascitic fluid culture was negative possibly as the patient was already on antibiotics. Blood cultures reported from the outside hospital were positive for Raoultella ornitholytica and sensitive to cefazolin and TMP/SMX but resistant to ampicillin. The repeat blood cultures here were negative. The patient underwent EGD which demonstrated Grade II esophageal varices with no stigmata of recent bleeding, and congestive gastropathy due to portal hypertension. Plan was to repeat EGD in 1 year. The patient was stabilized after resuscitative measures and antibiotics. He was discharged home after a few days of hospitalization with cefazolin and metronidazole. Discussion: Raoultella ornitholytica is an emerging bacterium with potent virulence. It is very rare in the case of liver cirrhosis patients but should be dealt with attention.Figure 1.: EGD demonstrated Grade II esophageal varices with no signs of recent bleeding.
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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 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".