1 Introduction
Necrotising soft tissue infections (NSTIs) can be defined as infections
of any of the layers within the soft tissue, comprising the dermis,
subcutaneous tissue, superficial fascia, deep fascia, or muscle. The
mortality rate for patients with these infections is high, even in cases
of invasive surgical treatment and adequate antibiotic therapy (1). The
NSTIs are classified into three types: type 1 is a polymicrobial
infection and is the most common form of NSTI; type 2 is a monomicrobial
infection caused by Streptococcus pyogenes orStaphylococcus aureus ; and type 3 is a monomicrobial infection
caused by gram-negative bacilli such as Vibrio spp .
(2). Escherichia coli as a cause of NSTI was initially thought to
be very rare; however, E. coli has recently been recognised as a
principle pathogen in monomicrobial NSTIs, and it is common among
chronically ill patients with NSTIs (3,4). A versatile pathogen,E. coli causes a wide range of extraintestinal diseases, such as
urinary tract infection, meningitis and bacteraemia. Until now, however,
few reports have analysed the virulence factors of the isolated strains
or host susceptibility for E. coli in NSTIs (4). This case report
presents a patient with alcoholic liver cirrhosis and NSTI caused byE. coli with various virulence genes.