title: Deep pyoderma caused by Burkholderia cepacia complex associated with ciclosporin administration in dogs: a case series.
abstract: BACKGROUND
  Bacteria of the Burkholderia cepacia complex (Bcc) are ubiquitous Gram-negative bacilli associated with fatal nosocomial infections in humans; multi-antibiotic resistance makes this organism a serious threat in hospital settings.
  
  
  OBJECTIVE
  To describe the historical, clinicopathological and treatment characteristics of Bcc-associated deep skin infections in dogs.
  
  
  METHODS
  Six dogs with skin infections in which skin bacterial cultures resulted in pure growth of Bcc.
  
  
  METHODS
  Retrospective study with review of medical records and skin biopsies.
  
  
  RESULTS
  All dogs were receiving oral ciclosporin at the time of skin infection development. All dogs were castrated males and four of six were West Highland white terriers. Cutaneous lesions consistent with deep pyoderma were confined mainly to the trunk. In all dogs skin cytology revealed a strong inflammatory response, with moderate to abundant numbers of intracellular (neutrophils and macrophages) and extracellular bacilli. In three dogs histopathology showed a multifocal, nodular to coalescing pyogranulomatous dermatitis associated with multifocal folliculitis and furunculosis. Tissue Giemsa and Gram stains identified numerous Gram-negative rods within macrophages. Antimicrobial susceptibility testing revealed multidrug-resistant Bcc strains with sensitivity to trimethoprim/sulfonamides in all dogs and to marbofloxacin, piperacillin and ceftazidime in three dogs. Successful treatment was achieved in all dogs using trimethoprim/sulfonamides or quinolones (marbofloxacin, ciprofloxacin) or doxycycline in conjunction with ciclosporin withdrawal.
  
  
  CONCLUSIONS
  Clinicians should be aware of the rare potential for Bcc-associated deep skin infections in dogs receiving oral ciclosporin. Owners should be made conscious of the potential transmission risk to humans or other animals.
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.|Center for Comparative Medicine and Translational Research, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Frane
authors.initials: F
authors.lastname: Banovic
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Ave, C339 VMC, St Paul, MN, 55108, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Koch
authors.affiliation: Animal Skin and Allergy Service, Melbourne Veterinary Specialist Centre, 70 Blackburn Road, Glen Waverley, VIC, 3150, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Robson
authors.affiliation: Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Jacob
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.|Center for Comparative Medicine and Translational Research, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Thierry
authors.initials: T
authors.lastname: Olivry
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019121:Burkholderia Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D042602:Burkholderia cepacia complex; D016572:Cyclosporine / Q000009:adverse effects*; D004283:Dog Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D004285:Dogs; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D011711:Pyoderma / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D012189:Retrospective Studies; D012867:Skin / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine