PMC9669447_01
Timeline from admission for the primary aortic valve replacement until microbial diagnosis by 16S rRNA sequencing of valve material.
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F1
The further disease course, diagnostics and treatment in this case is illustrated in the timeline of Figure 1.
Pre-operative transesophageal echocardiogram. Severe aortic regurgitation and thickened aortic wall.
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F2
Finally, transesophageal echocardiogram was performed Day 86, showing pendulating material at the ventricular side of the aortic valve cusps, consistent with endocarditis (Figure 2).
Excised valve material, acridin stain. Rods marked by white arrows.
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F3
Microscopy of acridin stained excised valve material demonstrated scarcely distributed rods (Figure 3), but culture of the explant on standard bacterial and fungal media did not yield growth.