Salmonella-Induced Immunothrombosis: An Unusual Case of Pulmonary Embolism in the Setting of Enteric Infection
Bibliographic record
Abstract
Diabetic ketoacidosis (DKA) is a well-recognized metabolic emergency, often precipitated by infection or stress. Non-typhoidal Salmonella (NTS) gastroenteritis is usually self-limiting but can assume clinical significance in metabolically compromised patients, occasionally precipitating thrombotic complications. We describe a unique case where gastroenteritis in the setting of DKA was associated with pulmonary embolism (PE) in an ambulant patient. A 46-year-old previously healthy woman presented after a minor fall complicated by a seizure. Imaging revealed an incidental calcified right-frontal meningioma. Baseline investigations demonstrated new-onset diabetes with DKA and severe iron-deficiency anaemia, managed with insulin, fluids, and oral iron. On day seven, she collapsed with hypotension, tachycardia, and hypoxia. A Wells score of 6, right-ventricular dilation on bedside echocardiography, and markedly elevated D-dimer raised suspicion for PE, confirmed on CT pulmonary angiography. Anticoagulation with apixaban was commenced. Within 24 hours, she developed acute diarrhoea; stool cultures isolated NTS serogroup B. She received targeted ciprofloxacin with full clinical recovery. This case illustrates that acute Salmonella gastroenteritis in the metabolically stressed state of DKA can precipitate immunothrombosis and PE, even without systemic sepsis. It underscores the importance of timely recognition of PE in unexplained collapse and the need for integrated multidisciplinary management across neurological, endocrine, haematological, and infectious domains.
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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 | 0.001 | 0.005 |
| 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 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 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".