Unexpected sepsis due to Group A beta haemolytic <i>Streptococcus</i> following total thyroidectomy
Bibliographic record
Abstract
Thyroidectomy is a clean surgery, with the presentation of postoperative infections being uncommon and an exceedingly rare incidence of postoperative sepsis. A female patient in her early 80s became acutely unwell following total thyroidectomy within the immediate postoperative period, with features suggestive of sepsis. She developed new-onset atrial fibrillation (AF), and her care was escalated to the intensive treatment unit (ITU) on the same day postoperatively. While in the ITU, she deteriorated with multiorgan failure (MOF). There was no evidence of a surgical site infection (SSI). Beta haemolytic lancefield Group A Streptococcus (GAS) was isolated from positive blood cultures, confirming the diagnosis of streptococcal toxic shock syndrome (TSS). She was treated with targeted antibiotics and intravenous immunoglobulin (IG) and received supportive care for MOF. In our case, sepsis developed in the immediate postoperative period of total thyroidectomy. A high index of suspicion and prompt treatment are required to minimise the risks of morbidity and mortality.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 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".