Clinical and histopathological features of Burkholderia cepacia complex dermatitis in dogs: a series of four cases.

Abstract

BACKGROUND: The Burkholderia cepacia complex (Bcc) is an emerging cause of opportunistic infections. Deep pyoderma associated with Bcc infection has been reported previously in dogs receiving ciclosporin. OBJECTIVE: To report the clinical and histopathological features of four additional cases of Bcc dermatitis in dogs, one of which progressed to septicaemia. ANIMALS: Four dogs with a skin culture yielding growth of Bcc and skin biopsies for histopathological investigation. METHODS AND MATERIALS: Retrospective review of medical records and skin biopsies and PCR for Burkholderia on DNA extracted from paraffin-embedded skin and liver to confirm Bcc sepsis. RESULTS: Three different breeds and one mixed breed dog were represented. Two dogs were receiving ciclosporin and one was receiving oclacitinib. One dog had no evidence of immunosuppression. One dog was bathed two days prior to onset of skin lesions. Three dogs presented with dorsally orientated ulcers, crusts and draining tracts; one dog had infection localized to a surgical site. The main histological feature from skin biopsies was severe neutrophilic folliculitis and furunculosis with marked neutrophilic to pyogranulomatous dermatitis. Intracellular Gram-negative and Warthin-Starry positive rods were present in three of four cases. Three dogs were successfully treated with systemic fluoroquinolones or trimethoprim sulfamethoxazole. The Bcc isolate in one dog was resistant to all tested systemic antimicrobials. This dog developed septicaemia and was euthanized. CONCLUSIONS AND CLINICAL IMPORTANCE: Bcc skin infections can occur in immunocompetent and immunocompromised dogs. Bcc isolates may be extensively antimicrobial resistant, presenting a challenge for clinical management. Cutaneous infection may progress to life-threatening sepsis.