Purulent Pericarditis as an Initial Manifestation of Infective Endocarditis in a Hemodialysis Patient: A Case Report
Bibliographic record
Abstract
INTRODUCTION: Infective endocarditis can present with a wide range of cardiac and extra-cardiac symptoms. However, purulent pericarditis as a presenting sign has rarely been documented in the literature. CASE DESCRIPTION: We present a case of a 47-year-old woman on hemodialysis who presented to the emergency department due to dyspnea and edema in her lower extremities. A chest X-ray revealed an enlarged cardiac silhouette, while a computed tomography (CT) scan showed a large pericardial effusion. A transthoracic echocardiogram indicated vegetation on the tricuspid valve and pericardial effusion, with echocardiographic signs of cardiac tamponade. Emergent drainage of the pericardial space was performed, during which purulent material was obtained. Methicillin-resistant Staphylococcus aureus was identified in blood cultures collected upon admission and in the cultures from the pericardial effusion. The patient received intensive antibiotic therapy; however, despite the treatment and after a complicated hospital course, she succumbed to the illness. CONCLUSION: Diagnosing purulent pericarditis in hemodialysis patients with infective endocarditis requires a high level of suspicion because typical symptoms of pericarditis are uncommon, and there is a tendency to initially attribute nonspecific constitutional symptoms to the underlying infection itself. Aggressive treatment with pericardial drainage and appropriate antibiotic therapy may prevent catastrophic outcomes.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| 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".