Varicella Zoster Virus-induced Acute Retinal Necrosis Following Acute Meningoencephalitis in a Patient with Presumed COVID-19
Why this work is in the frame
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Bibliographic record
Abstract
Purpose: To report the coincidence of acute retinal necrosis (ARN) syndrome following acute meningoencephalitis and presumed coronavirus disease 2019 (COVID-19) in an immunocompetent patient. Case Report: A 58-year-old female presented to our emergency department with sudden unilateral visual loss following a recent hospitalization for viral meningoencephalitis. Magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, polymerase chain reaction (PCR) of the aqueous humor, reverse transcription polymerase chain reaction (RT-PCR) of the nasopharyngeal swab specimen, chest computed tomography (CT), and fundus photography were performed for the patient. Ophthalmic examination revealed severe ocular inflammation and yellowish patches of necrotizing retinitis in the right eye, compatible with the diagnosis of ARN. The result of aqueous humor PCR was positive for varicella zoster virus (VZV). The patient received a single intravitreal ganciclovir injection and 10 days of intravenous ganciclovir, followed by oral acyclovir. The patient underwent COVID-19 screening tests: while the chest CT scan showed features highly suggestive of COVID-19, the RT-PCR was negative on two occasions. Two months later, best-corrected visual acuity improved to 20/70 in the right eye, the anterior chamber reaction and keratic precipitates resolved, and the vitreous haze decreased significantly. Conclusion: A case of VZV-induced ARN following acute meningoencephalitis was observed in association with presumed COVID-19. This could be an incidental finding during the COVID-19 pandemic; however, it could also suggest that COVID-19 might trigger ARN in cases with latent herpes family viruses.
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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 | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 it