PMC8739271_01
The head CTA scan of patient (Apr 19, 2021). Slightly high-density nodules were observed in the left frontal lobe and temporal lobe. The largest nodules were located in the frontal lobe, with a size of about 2.8 x 2.4 cm (Arrow indicating part). Shadow shuttling of arterial vessels was observed at the edge, without obvious thickening and tortuosity. The intraventricular system was hydrocephalic and dilated, accompanied by interstitial cerebral edema. Some sulci in bilateral cerebral hemispheres became narrow and unclear, and the density of tentorium cerebellum increased slightly.
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F1
Moreover, extensive soft tissue swelling in the abdominopelvic cavity, subcutaneous fluid accumulation, a nodular and lamellar hypodense shadow in the left gluteus maximus and gluteus medius muscles were observed, suggesting a tendency of inflammatory lesions (Figure 1).
Culture plates showing the growth of Elizabethkingia miricola. The blood plate colony is yellow, translucent, round, with neat edges (A). Gram-negative bacilli can be seen 1,000 times under the oil lens of blood culture (B).
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F2
Besides, cerebrospinal fluid bacterial culture identified Elizabethkingia meningoseptica (++++) (Figure 2).
The 16s sequencing comparison result of blood culture samples from patients was Elizabethkingia, and the final sequencing result was Elizabethkingia miricola
(A). NCBI comparison of 16S sequencing results (B). Primer: 27F AGTTTGATCMTGGCTCAG; Reverse: 1492R GGTTACCTTGTTACGACTT. The 16S amplified sequence of the sample was 100% compared with that of Elizabethkingia miricola.
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F3
The cerebrospinal fluid culture specimen was subjected to PCR and mass spectrometry analysis, where it was also identified as Elizabethkingia miricola (Figure 3).