case_images: PMC11390419_01
case_images: Microscopic image of a Gram-stained smear of Streptobacillus moniliformis from knee joint fluid culture in BD BACTEC  Peds Plus  bottle when growth was detected by BD BACTEC FX blood culture system, demonstrating pleomorphic and irregular Gram-negative rods in contact with neutrophils and also debris. Magnification, x 1000.
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case_images: PMC11390419_01_fmed-11-1345354-g0001.jpg
case_images: F1
case_images: The Gram-stained smear revealed pleomorphic and irregular Gram-negative rods (Figure 1).
case_images: Three-day culture in capnophilic atmosphere on 5% sheep blood agar (BD  Columbia Agar with 5% Sheep Blood, BD) showing tiny, non-hemolytic, pale gray, smooth and slightly shiny colonies.
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case_images: PMC11390419_01_fmed-11-1345354-g0002.jpg
case_images: F2
case_images: This growth evolved, developing small, pale gray, shiny, round-shaped non-hemolytic colonies after 48 h of incubation (Figure 2).
case_images: Three-day culture in capnophilic atmosphere in BBL  Schaedler Broth with Vitamin K1, BD, showing the typical "puffball" growth characteristic of Streptobacillus moniliformis after gentle agitation of the broth.
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case_images: PMC11390419_01_fmed-11-1345354-g0003.jpg
case_images: F3
case_images: Hinton agar with 5% horse blood and 20 mg/L ss-NAD did not yield any results. However, the strain subculture in Schaedler broth displayed the characteristic "puffball" growth pattern associated with S. moniliformis (Figure 3).
case_images: Relevant data from the episode of care organized as a timeline.
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case_images: PMC11390419_01_fmed-11-1345354-g0004.jpg
case_images: F4
case_images: Figure 4 shows a timeline of relevant data from the episode of care.