PMC6022317_01
Relatedness of Streptococcus equi subsp. zooepidemicus. A midpoint-rooted phylogenetic analysis using a maximum likelihood-approximation of concatenated MLST allele for all publically available ST types, except ST's 248, 324 and 359 from which yqiL is partially lost. The location of ST379 is highlighted. The scale bar reflects genetic distance in expected number of nucleotide changes per site.
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The isolate carried a novel sequence type (ST379), and a phylogenetic analysis using FastTree v2.1.5 of the concatenated MLST alleles (Figure 1) found it to cluster in a branch containing ST60, ST135 and ST162.
Illustration of the patient's transesophageal echocardiography demonstrating the vegetation on the aortic valve by the white arrow.
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TEE, resp.) demonstrated a vegetation on the aortic valve (Figure 2) with a minimal aortic insufficiency. There were no signs of paravalvular abscesses and no stenosis of the affected valve.
Illustration of the patient's left shoulder by Technetium-99m scintigraphy.
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Ten days later technetium-99m bone scintigraphy showed intense activity in the left shoulder, suspicious of osteitis (Figure 3).