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case_images: (A) Color flow Doppler ultrasonography of the abscess performed initially. The examination detected hypoechoic sound and identified a liquid dark area with poorly defined borders within the mass of approximately 31 mm x 11 mm in size. (B) Reexamination using color flow Doppler ultrasound after 3 days. The reexamination detected hypoechoic sound and revealed that the liquid dark area with poorly defined borders was 33 mm x 17 mm x 12 mm. The overall mass was approximately 50 mm x 35 mm x 25 mm in size.
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case_images: Color flow Doppler ultrasonography of the abscess revealed a liquid dark area within the larger mass of approximately 31 mm x 11 mm in size ( Figure 1A ). Reexamination using color flow Doppler ultrasound showed that the liquid dark area was 33 mm x 17 mm x 12 mm, and the overall mass was approximately 50 mm x 35 mm x 25 mm in size, suggesting a purulent inflammatory mass ( Figure 1B ).
case_images: (A) Colonies of Isolate A after 48 h of culture on blood agar plate under anaerobic conditions. (B) Colonies of Isolate B after 48 h of culture on blood agar plate under anaerobic conditions. (C) Gram staining of Isolate A showing gram-positive bacteria appearing as small rods. (D) Gram staining of Isolate B showing gram-positive bacteria appearing as rods.
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case_images: Isolate A colonies were approximately 1 mm in diameter and were round, white, opaque, smooth, raised, and hemolytic ( Figure 2A ). B colonies were round, gray, opaque, smooth, flat, and moist but not hemolytic ( Figure 2B ). Both types of bacterial colonies were catalase and oxidase negative. Smear staining of both colonies revealed small gram-positive rods in Isolate A ( Figure 2C ) and gram-positive rods in Isolate B ( Figure 2D ).
case_images: Phylogenetic tree showing the relationships of the patient's isolates to related species. The neighbor-joining tree was generated with the MEGA11.0 program using maximum composite likelihood method. Bootstrap values were calculated from 1,000 trees. The scale bar indicates the estimated number of substitutions per 50 bases.
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case_images: OR294027 and OR294028) analysis and phylogenetic tree analysis ( Figure 3 ) further verified that the two bacterial species were A. schaalii and A. turicensis.
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