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Record W4415769071 · doi:10.7759/cureus.95917

Bilateral Granulomatous Keratic Precipitates Following Inadequate Antibiotic Coverage for Presumed Lyme Disease

2025· article· en· W4415769071 on OpenAlexaff
Michael J Miyashiro, Nikki P Inamine, Gary S Inamine

Bibliographic record

VenueCureus · 2025
Typearticle
Languageen
FieldImmunology and Microbiology
TopicBartonella species infections research
Canadian institutionsEyeball (Canada)
Fundersnot available
KeywordsLYMELyme diseaseDoxycyclineAzithromycinCorticosteroidAntibioticsDiscontinuation

Abstract

fetched live from OpenAlex

, is a multisystem infection with diverse ocular manifestations. Although ocular involvement is uncommon, it can include conjunctivitis, keratitis, uveitis, and optic neuropathy. We describe a 61-year-old man who developed bilateral mutton-fat keratic precipitates following a tick bite and incomplete systemic antibiotic coverage. His course was complicated by premature discontinuation of doxycycline and systemic corticosteroid exposure. Ophthalmic examination revealed bilateral granulomatous keratic precipitates without anterior chamber reaction. He was prescribed systemic azithromycin and referred to an infectious disease specialist for further evaluation. At the one-month follow-up, the patient demonstrated complete resolution of keratic precipitates and anterior chamber inflammation after completing azithromycin therapy, without the need for adjunctive corticosteroid use. This case underscores the importance of considering Lyme disease in the differential diagnosis of bilateral granulomatous keratic precipitates. Diagnostic challenges included an early false-negative serologic result, premature discontinuation of antibiotics, and corticosteroid exposure without adequate antimicrobial coverage. Bilateral granulomatous keratic precipitates may represent an early ophthalmic marker of systemic Lyme disease. Prompt recognition, initiation of systemic antibiotic therapy, and referral to an infectious disease specialist are essential to prevent long-term sequelae.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.005

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.002
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.013
GPT teacher head0.292
Teacher spread0.279 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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