A Case Report of Herpes Simplex Virus Associated Peritoneal Dialysis Peritonitis With Novel Use of Intraperitoneal Acyclovir
Bibliographic record
Abstract
Viral etiologies, such as herpes simplex virus (HSV), for peritonitis can be misclassified as culture negative peritonitis because of poor accessibility of viral testing in the effluent fluid. Inaccurate diagnosis and subsequent ineffective treatment can lead to unnecessary catheter removal for presumed refractory peritonitis. Here, we report a 73-year-old woman with a history of genital HSV-2 on continuous cyclic peritoneal dialysis who presented with HSV-2 related peritonitis. She initially presented with hypotension, suprapubic pain, and cloudy effluent with an elevated white blood cell count preceded by a 1-week history of genital lesions. Elevated cell counts were primarily lymphocyte and monocyte predominant. Bacterial and fungal cultures were negative, and she had minimal improvement in cell counts after 1 week of empiric antibiotics. Effluent was positive for HSV-2. Acyclovir was reconstituted in a 2.5% Dianeal bag and administered via the intraperitoneal route for local effects and avoidance of neurotoxicity. Her cell counts normalized within a week of starting intraperitoneal antiviral therapy and repeat effluent was negative for HSV at 2 weeks. There is one case report describing HSV-2 related peritonitis; however, to our knowledge, this is the first case of viral peritonitis treated with IP acyclovir successfully.
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How this classification was reachedexpand
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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".