Necrotising fasciitis associated with Escherichia coli in a dog

Abstract

CASE HISTORY: Lameness and limb pain associated with a laceration in the inner thigh of a Border Collie dog progressed over 4 days to extensive necrosis of the full-thickness of skin and subcutaneous (S/C) tissue. A successful outcome was achieved using surgical debridement and intensive supportive care, followed by limited local closure, axial pattern flap development, and free skin grafting.

CLINICAL FINDINGS: Clinical findings included severe pain, depression, pyrexia and hypoalbuminaemia, and full-thickness loss of skin from the caudal thigh to the hock. Histopathologically, debrided tissue showed extensive necrosis of the dermis, adipose and muscle tissues, and the presence of numerous Gram-negative rods. Escherichia coli was cultured from deep tissue samples.

DIAGNOSIS: Necrotising fasciitis (NF) associated with E. coli infection.

CLINICAL RELEVANCE: NF associated with E. coli has not been previously reported in dogs. The importance of early diagnosis and surgical debridement is noted and the relevant medical literature is reviewed.

KEY WORDS:

• Necrotising fasciitis
• superficial epigastric axial pattern flap
• full thickness skin grafting
• E. coli

Acknowledgements

The authors would like to thank anaesthetists Roslyn Machon and Vicki Walsh, interns Kathleen Limpus and Ilana Burton, and the nurses and students of the MUVTH for their outstanding care of the patient. Thank you also to Dr Patrick Kelly for help preparing the manuscript, Alex Grinberg for the microbiology, and Angela Ford for referring this case to the MUVTH.