A case of disseminated blastomycosis in New England
Bibliographic record
Abstract
infections are classified as dimorphic fungal infections commonly seen geographically throughout the Mississippi and Ohio River Valleys, St. Laurence Seaways, as well as the Canadian providences of Ontario Manitoba, and Saskatchewan. Although primarily endemic in the Midwestern United States, there has been a rise in cases throughout New England. Factors that could contribute to this rise of blastomycosis include a changing climate, increasing use of immunosuppressive medications as well as a greater recognition of this disease. Initial presentation of blastomycosis follows the inhalation of fungal spores which can cause flu-like symptoms or mimic acute pneumonia. Blastomycosis can also present as a disseminated infection through extrapulmonary spread in both immunocompromised and immunocompetent hosts and cases present at similar rates within the population. Here we present a case of disseminated blastomycosis in a patient from New England with no reported pre-existing risk factors. The patient developed blastomycosis osteomyelitis in the left elbow which prompted surgical intervention as well as a 12-month regimen of voriconazole therapy. This case outlines the need to adopt better surveillance practices for blastomycosis in non-endemic areas as well as highlights the imperative role of healthcare staff in implementing proper reporting measures to track the spread of blastomycosis.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| 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".