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A case of extensively drug-resistant staphylococcal para-aural abscess treated with photodynamic therapy in a West Highland White Terrier presenting chronic otitis and craniomandibular osteopathy.

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A 10-year-old dog with chronic unilateral otitis and a history of unsuccessful systemic and topical antibiotic treatments was referred. A computer tomography scan (CT scan) revealed unilateral chronic otitis with… Click to show full abstract

A 10-year-old dog with chronic unilateral otitis and a history of unsuccessful systemic and topical antibiotic treatments was referred. A computer tomography scan (CT scan) revealed unilateral chronic otitis with calcification of the ear canal, abscessation and fistulas. On bacterial culture a Staphylococcus pseudintermedius sensitive to pradofloxacin was isolated. Systemic treatment with pradofloxacin 3 mg/kg per os once daily improved the infection and the dog had total ear canal ablation and bulla osteotomy performed. After one month, despite antibiotic treatment new fistulas developed in the same area. Bacterial culture revealed an extensively drug-resistant S. pseudintermedius sensitive to rifampicin. Under general anaesthesia, the area was cleaned with 0.5% saline solution and 1 mL of indocyanine green (Emundo®, A.R.C.) was injected into the fistulas. A treatment with diode laser (A.R.C. Laser 810 nm, GmbH, Nurnberg, Germany) of four cycles 500 mw for 30 s, with a dosage of 50 J/cm2 in the affected area was performed. No antibiotic was administered and one week later, 50% of the fistulas were closed with a significant improvement of the patient's clinical condition. Cytology and bacterial culture were negative 72 h after the treatment. Total recovery occurred after two weeks. Photodynamic treatment is a promising antibacterial technique in case of localized refractory bacterial skin infections.

Keywords: photodynamic therapy; treatment; extensively drug; drug resistant; chronic otitis; otitis

Journal Title: Photodiagnosis and photodynamic therapy
Year Published: 2021

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