A four-year-old female spayed mongrel dog was presented in May 2015 with a two-year history of poorly controlled atopic dermatitis (AD) and increased pruritus over the last few months. Current medications included Apoquel, prednisone, diphenhydramine and cephalexin. A deep skin scrape revealed Demodex canis and Demodex cornei and superficial cytology revealed coccoid bacteria. Aerobic skin culture revealed meticillin-resistant Staphylococcus pseudintermedius (MRSP) and dermatophyte culture grew Microsporum canis. Therapy included discontinuation and taper of immunosuppressive medications, oral enrofloxacin and ivermectin and Malaseb shampoo. Complete resolution of demodicosis, dermatophytosis and MRSP was accomplished in four months. Long-term control of AD was established by using low-dose prednisone therapy with no relapse in infectious disease. This case illustrates the risk of development of multiple infectious diseases secondary to immunosuppression with multimodal drug therapy for treatment of AD, and it exemplifies the importance of performing in-house diagnostic testing.
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Contributors SLL is the primary author and the primary doctor managing the case clinically.
RM significantly contributed to editing, formatting and revising the case report, as well as advised on clinical case management.
TPL significantly advised the primary author with case management and contributed to editing, formatting and revising the case report.
AES contributed to editing, formatting and revising the case report and provided feedback and advise for case management.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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