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.