Bilateral Psoas Abscess Extended into Spinal Canal in a Patient with Long-Standing Poorly Controlled Diabetes Mellitus – A Case Report
Bibliographic record
Abstract
Psoas abscess is a relatively rare condition with varying clinical presentation. Therefore, the diagnosis and treatment are frequently delayed. Psoas abscess can extend into the spine and cause spinal infection or spinal infection can be a source for secondary psoas abscess. It has 100% mortality if left untreated. Broad-spectrum antibiotics and drainage of pus by either percutaneous drain insertion or open surgery are the treatment modalities. A 62-year-old patient, male patient with long-standing diabetes and ischemic heart disease presented with fever and lower back pain for four days duration without any systemic focus of infection. He was hemodynamically stable, and neurological examinations of the lower limb were normal on admission. He developed bilateral lower limb weakness on the 7th day of hospital stay, and neurological examinations of the lower limb revealed flaccid paralysis. His Contrast Enhanced Computerized Tomography (CECT) of the abdomen revealed a bilateral psoas abscess. Both pus culture and blood culture were positive for Methicillin-resistant staphylococcus aureus. Later, his Magnetic Resonance Image (MRI) spine revealed infective multilevel spondylodiscitis, arachnoiditis, radiculitis, and early infective myelitis. The abscess was drained, and a broad-spectrum antibiotic was started. Unfortunately, he passed away despite maximal medication intervention due to septicemia, acute kidney injury, and septic shock. Even though rare, psoas abscess should be suspected in a patient with back pain, fever, and high inflammatory markers due to its high mortality and morbidity. Early diagnosis and treatment can reduce mortality and morbidity. However, advanced age, presence of bacteremia, and poorly controlled diabetes carry poor prognosis.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 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".