Endogenous Nocardial Endophthalmitis Misdiagnosed as Giant Cell Arteritis
Bibliographic record
Abstract
Steven Gagnon,1– 3 Marc Saab1,2,4– 6 1Département d’ophtalmologie et d’oto-rhino-laryngologie – chirurgie cervico-faciale, Université Laval, Québec, QC, Canada; 2Hôpital Régional de Rimouski, Centre intégré de santé et de services sociaux du Bas-Saint-Laurent, Rimouski, QC, Canada; 3Centre Universitaire d’ophtalmologie (CUO), Hôpital du Saint-Sacrement, Québec, QC, Canada; 4Hôpital Charles-LeMoyne, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Greenfield Park, QC, Canada; 5Service d’ophtalmologie, Université de Sherbrooke, Sherbrooke, QC, Canada; 6Département d’ophtalmologie, Université de Montréal, Montréal, QC, CanadaCorrespondence: Steven Gagnon 1083, rue du Chevreau, Lévis, QC G6Z 3C3, CanadaEmail gagn0n@hotmail.comPurpose: Endogenous endophthalmitis is uncommon but potentially dangerous. We present a fatal presentation of endogenous Nocardial endophthalmitis in the context of steroid use for treatment of giant cell arteritis.Case Presentation: An 84-year-old Caucasian female presented to the local emergency room with severe headaches, myalgia and shoulder and calf muscle pain. She was treated for a presumed diagnosis of giant-cell arteritis with corticosteroids and subsequently developed an intense retro-orbital pain in the right eye. Fundus examination revealed a white, vascularized chorioretinal mass at the equator of the eye in the inferotemporal quadrant. Antibiotics were given and a vitrectomy was performed. The culture of the vitreous showed Nocardia nova and a diagnosis of disseminated Nocardiosis was made.Conclusion and Significance: Although uncommon, it is important that ophthalmologists are aware of Nocardial infections as a differential diagnosis of retinal mass, particularly in immunocompromised patients.Keywords: Nocardiosis, systemic, Nocardia, eye, intraocular, endophthalmitis, endogenous
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 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) | 0.002 | 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".