JAUNDICE, UNREMITTING HYPERPYREXIA, HAEMATURIA AND IMPENDING SHOCK IN A 16 YEAR OLD BOY
Bibliographic record
Abstract
Objective To demonstrate the successful salvage of a 16 year old boy suffering from multiple organ failure, severe sepsis with impending Gram negative shock with aggressive combination antibiotic treatment. Method Case presentation: A 16 year old boy returning from India presented with a five day history of unremitting fever up to 41°C, non-responsive to treatment with amoxacillin and clavulanic acid, becoming severely lethargic, jaundiced and passing haematuria. Initial laboratory tests showed a WBC of 29000, platelet of 467,000, marked neutrophilia. Bilirubin up, 80 mg/l, and indirect bilirubin 64 mg/l. G6PD assay down to 0.7, significantly deficient and ASOT over 1500. C reactive protein was 1700. Haemolysis with marked haematuria was noted. Chest X ray showed bilateral bronchopneumonia. Blood culture positive of Salmonella typhi and sputum culture positive of Haemophilus influenzae and group G streptococci. The patient was suffering from bloody diarrhoea, reducing urine output, tachycardia with heart rate close to 170 and deminishing urine output. Physical examination revealed a boy in impending shock, with chills and rigors, excessive sweating and high fever. Results Aggressive salvage treatment: IVIG 20 grams given together with normal saline in 5% dextrose, IV tigecycline 100 mg and linezolid 600 mg, given simultaneously with dexamethasone 12 mg IV. He was completely afebrile. IV linezolid was discontinued after 36 hours with immediate resurgence of fever. Tigecycline was not sufficient to control the Gram positive sepsis. Reintroduction of linezolid induced immediate response. Conclusion 7 days of resistance defensive antibiotics is life saving.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| 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".