Article

An investigation of ear necrosis in pigs

Jeonghwa Park, Robert M. Friendship, Zvonimir Poljak, Josepha DeLay, Durda Slavic,
Catherine E. Dewey

Abstract — Porcine ear necrosis was investigated in 23 conveniently chosen farms, consisting of 14 case farms
and 9 control farms. Biopsies of lesions and oral swabs from pigs on 11 case farms were examined by histology
and bacterial culture. All farms were visited for observations and a survey on management, housing, and the pres-
ence of other clinical signs or behavioral vices. Histological examination revealed that the lesions began on the
surface and progressed to deeper layers, and that vascular damage did not appear to be the initiating cause.
Spirochetes were only rarely observed in histological examination and were not cultured from biopsies and oral
swabs. Staphylococcus aureus and Staphylococcus hyicus were cultured from 91% and 66% of samples, respectively.
Ear biting and a humid environment were associated with ear necrosis. On some farms large numbers of pigs were
affected and lesions were sometimes extensive. The condition appears to be an infectious disease beginning on the
surface of the skin; contributing environmental and management factors are likely.

Résumé — Enquête sur la nécrose des oreilles chez les porcs. La nécrose des oreilles porcines a fait l’objet d’une
enquête dans un échantillonnage de convenance de 23 fermes, composé de 14 fermes de cas et de 9 fermes témoins.
Les biopsies de lésions et des prélèvements oraux faits chez des porcs dans 11 fermes de cas ont été examinés par
histologie et culture bactérienne. Toutes les fermes ont été visitées pour recueillir des observations et effectuer un
examen de la gestion, du logement et de la présence d’autres signes cliniques ou vices de comportement. L’examen
histologique a révélé que les lésions commençaient sur la surface et progressaient vers des couches plus profondes
et que les dommages vasculaires ne semblaient pas être la cause initiale. Des spirochètes ont été rarement observés
à l’examen histologique et n’ont pas été cultivés dans les biopsies et les prélèvements oraux. Staphylococcus aureus
et Staphylococcus hyicus ont été cultivés dans 91 % et 66 % des échantillons, respectivement. Les morsures d’oreilles
et un environnement humide étaient associés à la nécrose des oreilles. Dans certaines fermes, un grand nombre de
porcs étaient affectés et les lésions étaient parfois importantes. L’affection semble être une maladie infectieuse qui
commence à la surface de la peau; des facteurs contributifs liés à l’environnement et à la gestion sont probables.
(Traduit par Isabelle Vallières)
Can Vet J 2013;54:491–495

Introduction
Ear necrosis is a common problem on Canadian pig farms and
several etiologies have been proposed but not confirmed. The
clinical manifestation of ear necrosis has been described as the
appearance of open wounds, crust, and bleeding on 1 or both
Department of Population Medicine, Ontario Veterinary
College, Guelph, Ontario (Park, Friendship, Poljak, Dewey),
Animal Health Laboratory, University of Guelph, Guelph,
Ontario (DeLay, Slavic).
Address all correspondence to Dr. Jeonghwa Park; e-mail:
jeonghwa@uoguelph.ca
Use of this article is limited to a single copy for personal study.
Anyone interested in obtaining reprints should contact the
CVMA office (hbroughton@cvma-acmv.org) for additional
copies or permission to use this material elsewhere.
ears (1). Little is understood regarding the risk factors that
influence severity and prevalence of ear necrosis. In general, ear
necrosis is considered to have little effect on pig performance, at
least when the lesions are only mild to moderate (2). However,
the unsightly visual appearance could interfere with the sale of
affected pigs, and raise welfare concerns.
The etiology of ear necrosis is unknown. Staphylococcus hyicus
and Staphylococcus aureus have been suggested as potential
causative agents because of the similarity of histopathological
lesions and bacterial cultural results between ear necrosis and
exudative epidermitis (3–5). The pathogenesis of staphylococcal
skin disease involves bacterial production of exfoliative toxins
(ETs) which act as “molecular scissors” to cleave the epidermis
of mammalian skin (6). For a long time it was thought that
S. aureus ETs did not affect the epidermis of pigs (7); however,
recent findings have demonstrated the targeting of desmoglein1
in pig skin by S. aureus ETB and ETD (6). Spirochetes have

CVJ / VOL 54 / MAY 2013 491

 also been considered as potential causative agents of ear necrosis
(8) and in 1 recent study spirochetes (genus Treponema) were
cultured and identified from ear necrosis lesions (9).
Clinical lesions of ear necrosis need to be differentiated from
secondary skin lesions developing occasionally at ear tips as
a result of vasculitis associated with systemic diseases such as
salmonellosis and classical swine fever (10). An argument has
A R T I C LE
been made that ear necrosis is the result of ischemic injury due
to thrombosis of the small dermal capillaries in the tips of the
ears as a result of immune-complex deposition, as occurs in
porcine circovirus associated disease (PCVAD) (11), or due to
mycotoxin-associated vasculopathy (10).
Ear necrosis appears to be influenced by environmental
and management factors. Purchased feed, fully slatted floor-
ing without straw, poor air quality and high humidity, and a
high stocking density of newly weaned pigs have been found to
increase the risk of ear necrosis (12). Dry feed, early weaning,
poor housing conditions, fighting, feed and dirt on the tips of
ears, and concurrent mange have also been identified as possible
risk factors (4,13).
The objectives of this study were to: describe clinical and
histopathological lesions of ear necrosis; determine the presence
of potential pathogens, particularly Staphylococcus species and
spirochetes; and determine herd-level risk factors of ear necrosis.
Materials and methods
A total of 23 conveniently selected farms were used in the study
(14 case farms and 9 control farms). To be included as a control
farm, the farm owner or manager had to report that the farm
had no history of clinical signs of ear necrosis, and the absence
of ear necrosis had to be confirmed by the researchers through
an on-farm visit. All farms were visited between May 2010 and
April 2011, and the observations were conducted by the same
individual on all farms. The research was approved by the animal
care committee of the University of Guelph.
Investigation of potential causative organisms
Sampling for bacterial culture
Material for diagnostic purposes was collected from 11 of
the 14 case farms. On each farm, 9 pigs were selected for
testing by choosing 3 pigs from early, mid, and late stages of
clinical disease. Early-disease stage groups consisted of pigs
with small black scabs on their ears and were from pigs in the
youngest affected age group. Mid-disease stage groups were
slightly older (1 or 2 wk) and generally exhibited lesions that
had progressed to open wounds, thick scabs, and some loss
of ear tissue. Late-disease stage groups were the oldest pigs,
which generally showed lesions that had resolved but bleeding
wounds and thick scabs were still common. Three wedge-
shaped ear tissue biopsies and an oral swab were taken from
each pig. One biopsy sample was placed in a sterile plastic tube
for culture of S. hyicus and S. aureus. Another biopsy sample
was placed in a tube with fastidious anaerobe broth (FAB),
(LAB 71, Lab M, Heywood, Lancashire, UK) for culture of
spirochetes. A third biopsy sample was placed in a 100 mL
jar containing 50 mL of 10% formalin solution for histologic
examination. For the histology samples, an effort was made
492
to capture the margin of normal and lesional skin. A cotton
swab was used to sample the mouth (especially around the
gums) of the same pig and was placed in a tube with FAB
for culture of spirochetes. All samples were transported in an
insulated container and submitted on the day of collection by
taking them directly to the Animal Health Laboratory (AHL),
University of Guelph, Guelph, Ontario. Bacterial culture was
performed and bacteria were identified as S. hyicus and S. aureus
by standard laboratory techniques including colony morphol-
ogy, hemolysis, Gram-stain, catalase reaction, and coagulase
reaction. Antimicrobial susceptibility testing with penicillin G,
ampicillin, ceftiofur, spectinomycin, sulphonamide, tetracycline,
tiamulin, and trimethoprim/­sulfamethoxazole was determined
by the disk diffusion method (Kirby-Bauer Procedure) defined
by the Clinical and Laboratory Standards Institute (14). For
the purpose of analyzing the data, isolates classed as intermedi-
ate susceptibility were included with the bacteria identified as
resistant.
Culture of spirochetes was performed following the method
described by Pringle et al (9). Ear tissues and oral samples in
FAB were incubated for 24 to 48 h at 37°C in an anaerobic
chamber. One drop of the broth culture was added to a 0.22 mm
membrane filter placed on fastidious anaerobe agar with 10%
horse blood. Following incubation of the agar plate at 37°C for
2 to 3 days in an anaerobic chamber, the bacterial growth under
the filter was examined by phase contrast microscopy.
Histopathological examination
Following 24 h fixation in 10% neutral buffered formalin,
skin biopsies were processed for histologic examination. Where
sufficiently large, biopsies were bisected prior to processing,
and all biopsies were processed in total. Serial tissue sections
(4 mm) from each biopsy were stained with hematoxylin and
eosin (H&E) and Warthin-Starry silver (WS) and were examined
using light microscopy by a single pathologist (JD).
Immunohistochemistry (IHC) for Treponema spp. was per-
formed on tissue sections from those cases in which spirochetes
were identified by WS stain.
Investigation of risk factors at farm level
All 23 farms were visited and a questionnaire was administered to
the producers during a face-to-face interview. Information from
the questionnaire included: farm demographics, weaning age, pig
flow, cleaning procedures, vaccination and medication regimens,
feeding information, and source of pigs. In addition, observa-
tion notes for each disease-stage group were completed by the
researchers after collecting samples during the visit to the farm.
Information collected through on-farm observation included: the
prevalence of ear necrosis for each disease stage, a description of
the lesions, the presence of clinical signs other than ear necrosis
and the presence or absence of behavioral vices. A description of
the facilities, noting the stocking density, type of flooring, feeder
and waterer type, and room temperature was recorded. A subjective
assessment of humidity and air quality in the pen was recorded.
On control farms, groups of pigs that were comparable to the age
of early, mid, and late disease stages for case farms were chosen for
observation.
CVJ / VOL 54 / MAY 2013
Data management and statistical analysis
Information from survey questionnaires and observation notes
for each stage were entered separately into Epi-data Software
(EpiData Entry version 3; The EpiData Association, Odense M,
Denmark) and imported to Stata software (Stata Intercooled,
version 10; Stata Corporation, College Station, Texas, USA) for
further processing and analysis. Initially, data were checked for
accuracy, consistency, and missing values.
The average prevalence of ear necrosis in each stage group
was estimated as the number of pigs affected with ear necrosis
divided by total number of pigs in the pen.
Unconditional association between ear necrosis status of
farms and putative risk factors, obtained from the survey and
observation notes were evaluated using a chi-squared test or
Mann-Whitney U-test, as appropriate (P , 0.05). Variables
in the survey were measured at the farm level and the vari-
ables in the observation notes were measured for each of the
3 stage groups at farm-level. These were then offered as sepa-
rate variables in a different stage group modeling. Initially, a
total of 16 variables was obtained from the survey and each of
21 variables obtained in early, mid, and late stage groups from
the observation notes were examined. Correlation analysis was
performed using the Spearman’s rank correlation statistic to
identify collinearity among variables. Independent variables
associated with the dependent variable at a 20% significance
level (P , 0.2) in unconditional screening were considered
primary predictors of interest and were included in the multi-
variable main effects model. Then the presence or absence of
lesions of ear necrosis on the farm as the dependent variable
was regressed on these primary predictors using multivariable
logistic regression. Manual model building, which combined
forward selection, was employed in building a multivariable
model. Model fitting was evaluated by the Pearson Goodness of
fit test.
Results
Investigation of potential causative organisms
Staphylococcal culture
A total of 96 pigs were selected from 11 case farms (mean:
8.7 pigs/farm). The recovery rate of S. hyicus from ear tissue
biopsies was 66% and the recovery rate of S. aureus from ear
tissue biopsies was 91%. There was no significant difference
in the recovery rates (Wald X 2 P = 0.36). Both S. aureus and
S. hyicus were recovered from 58.3% of pigs, whereas S. aureus
was recovered alone from 32.3% of the pigs and S. hyicus was
recovered alone from 7.3% of the pigs. At the farm level, the
recovery rate was 90.9% (10/11) and 100% (11/11) for S. hyicus
and S. aureus, respectively, based on at least 1 positive isolate
from a farm. The recovery rates of S. hyicus were 76.9%, 66.7%,
66.7%, in early, mid, and late stages, respectively. The recovery
rates of S. aureus were 82%, 93.3%, and 90%, in early, mid,
and late stages, respectively. Antimicrobial resistance profiles
of S. hyicus and S. aureus isolates are presented in Figure 1.
The most common resistance pattern of S. hyicus isolates
was penicillin G-ampicillin-ceftiofur (27.8%), and the most
common resistance pattern of S. aureus isolates was penicillin
G-ampicillin-ceftiofur-tetracycline (20.4%).
CVJ / VOL 54 / MAY 2013
Case farms
S. hyicus
Percent of isolates resistant
S. aureus
A R T I C LE
Antimicrobials
Figure 1.  Antimicrobial resistance profiles of S. hyicus and
S. aureus from clinical cases of ear necrosis.
pen — penicillin G, amp — ampicillin, cef — ceftiofur, spec — spectinomycin,
tet — tetracycline, tia — tiamulin, sul — sulphonamide, trisul — trimethoprim-
sulfamethoxazole. Number of S. hyicus isolates is 63; number of
S. aureus isolates is 87.
Spirochetes
Attempts to culture spirochetes from ear biopsies and oral swabs
were unsuccessful. In WS-stained ear biopsies, spirochetes were
identified in 5 pigs (5.2%), including 4 pigs (11.1%, 4/36) from
the early stage group and 1 pig (3.7%, 1/27) from the mid-stage
group. Spirochetes in 4 of 5 WS-positive biopsies were confirmed
as Treponema spp. by IHC. Spirochetes were clustered within
crusts or pustules, or were located at margins of ulcerated foci in
the epidermis. In the spirochete-positive group, 3 pigs were posi-
tive for S. hyicus, S. aureus, and spirochetes (3.1%, 3/96); 1 pig
was positive for S. aureus and spirochetes (1%, 1/96); and 1 pig
was positive only for spirochetes (1%, 1/96). Farm prevalence of
spirochetes was 36.4% (4/11).
Histological examination
Biopsies from the majority of affected pigs demonstrated crust-
ing erosive to ulcerative pinnal dermatitis with variably severe
neutrophilic dermatitis and large numbers of bacterial cocci in
crusts. Lesions in affected pigs consistently involved epidermis,
and were typically more severe in epidermis than in underlying
dermis. Superficial dermal inflammation was dominated by neu-
trophils, with fewer lymphocytes and histocytes. In a few cases,
vasculitis or overt thrombosis was evident (6/96) and vascular
lesions were associated with foci of epidermal ulceration and
dermal necrosis/inflammation. Dermal granulation tissue and
fibrosis, indicative of lesion chronicity, were present in 25/96
(26%) cases.
Risk factors at the farm level
The average prevalence rates of ear necrosis on case farms were:
31.6% [standard deviation (SD): 32.8], 44.2% (SD: 36.1), and
54.8% (SD: 38.1)] for early, mid, and late stages, respectively.
The average ages of each disease stage group on case and control
farms are presented in Table 1. The degree of severity varied
between farm and within farm. The most severe lesions resulted
in the loss of as much as one-third of the ear.
493
 Table 1.  The average ages of pigs showing clinical signs of early,
mid, and late stage ear necrosis on case farms (n = 14) and the
ages of pigs on control farms (n = 9) that were used in the study
Early Mid Late Early-Lateb
Case (wk) 6.6 (3–12)a 7.7 (5–13) 10 (5–16) 3.7
Control (wk) 5.7 (3–12) 8.4 (6–12) 14 (8–20) 8.6
a Range.
A R T I C LE
b The mean of age-difference from early to late stage.
The variables in survey questionnaires, which were found to
be unconditionally associated with ear necrosis status of the farm
under P , 0.2, are presented in Table 2. Based on observation
notes, the variables in early, mid, and late stage groups, which
were unconditionally associated with ear necrosis status of the
farm under P , 0.2, are presented in Table 3. In the multivari-
able model of observation notes, the variables of perception of
high humidity and the presence of ear biting were significantly
associated with the presence of ear necrosis (Table 4). No evi-
dence of a confounding effect was found within the variables in
the final model. Similarly, no statistically significant interaction
effects were identified (P . 0.05). Visual assessment of residuals
was performed and this identified an outlier, but no coefficient
changes were shown without the outlier.
In the final multivariable model using results of the survey,
no variables were significantly associated with the presence of
ear necrosis under the 5% significance level.
From the survey, the source of semen and genetic composi-
tion of piglets, the breeds of sows and replacement gilts showed
a wide variety in both case and control farms. Small purebred
breeders and a number of multinational genetic supply compa-
nies contributed to supply semen and replacement gilts to both
case and control farms. In addition, there was no difference in
the types of farm between case and control farms.
Discussion
The low prevalence of spirochetes found by histological exami-
nation and the lack of spirochetes identified by culture in the
current study is similar to the findings of Richardson et al (3),
who also observed spirochetes in only a small number of affected
animals. It is possible that spirochetes were present but we were
not able to culture them. However, if spirochetes were the pri-
mary agent, one would expect their presence to be more promi-
nent in histological examination using silver staining techniques.
The evidence from this study suggests that these organisms are
more likely secondary invaders rather than primary pathogens.
In contrast, both S. aureus and S. hyicus were frequently iso-
lated from samples of the ear lesions. However these organisms
can be commonly isolated from the skin of pigs. In order to
determine whether these organisms play a role in the etiology
of ear necrosis it will be necessary to confirm that these isolates
can produce exfoliative toxins (ETs) and to conduct challenge
studies to reproduce the disease. Histological examination
showed lesions similar to the lesions of exudative epidermitis
such as severe epidermal inflammation with erosion, ulceration,
and crust with relatively mild dermal inflammation through all
stages of the disease (15). Our attempt to find early changes of
gross vesiculation (3) was unsuccessful; possibly, the very early
494
Table 2.  Descriptive statistics of variables in survey questionnaires
found to be unconditionally associated with ear necrosis status of
the farm (P , 0.2)
Variables Case mean (SD) Control mean (SD) P-value
Minimum weaning 16.9 (1.15) 27 (1.72) 0.05
  age (days)
Average weaning 20.7 (0.99) 28.6 (3.31) 0.06
  age (days)
Number of sows 871.1 (287.07) 357.4 (121.15) 0.2
  on farm
Zinc level in feed
  (ppm) 191.3 (41.7) 1009.8 (465.7) 0.2
Downtime after 1.9 (0.32) 1.1 (0.4) 0.2
  washing (days)
SD — standard deviation.
Table 3.  Descriptive statistics of variables unconditionally
associated (P , 0.2) with pigs showing clinical signs of early,
mid, and late stage ear necrosis based on observations
Variables Compared with P-value
High humidity in the pen Moderate and low humidity 0.01
  in the pen
Presence of ear biting 0.01
Presence of tail biting 0.01
Low availability of drinkers 0.01
  per pig
Presence of scratches 0.06
Low availability of feeders 0.06
  per pig
Concrete solid floor Half slatted and wholly slatted 0.07
Low availability of space 0.09
  per pig (ft2)
Bowl drinker Bowl 1 nipple and nipple 0.12
 drinker
High temperature (°C) 0.15
lesions may have been too subtle to be recognized when pigs
were chosen for sampling or at the time of the visit there were
no pigs available at the very earliest stage.
In the current study, the staphylococcal isolates showed a high
degree of resistance to some of the commonly used antibiotics,
suggesting that bacterial resistance might lead to poor response
to antibiotic treatment.
The low prevalence of vascular lesions in biopsies from the
study suggests that ear necrosis does not represent a manifesta-
tion of PCVAD (11); the vascular lesions appear to have devel-
oped secondarily to epidermal inflammation. In addition, the
case farms were not associated with other clinical signs such as
depression, respiratory disease, or enteric disease that could be
indicative of infections with PCV2 or other systemic diseases.
As well, the advent of widespread PCV2 vaccination and sig-
nificant reduction in PCVAD has not eliminated or reduced
the occurrence of ear necrosis in the case herds. The results are
consistent with the study by Lang et al (16) who investigated
the role of PCV2 and couldn’t detect virus in the lesions when
using PCV2 in-situ hybridization testing. Mycotoxins were not
investigated but the histological description of the lesions and
the lack of other clinical signs associated with mycotoxicosis
tend to rule out their involvement.
Ear biting was strongly associated with the presence of ear
necrosis in the study. Trauma from ear biting has been suggested
to be the triggering factor in allowing infectious agents to invade
CVJ / VOL 54 / MAY 2013
Table 4.  Herd level factors associated with ear necrosis in the
final multivariable logistic regression model based on observational
data (P , 0.05)
Variable OR OR (95% CI) P-valuea
Presence of ear biting 22.34 1.09–459.49 0.04
High humidity level (versus low) 52.63 2.81–1000 0.01
Number of observations: 24
AUCb: 0.90
AICc: 22.61 BICd: 26.14
OR — odds ratio.
a Wald test was used to determine statistical differences.
b AUC — area under the ROC (receiver operating characteristic) curve.
c AIC — Akaike’s Information Criteria.
d BIC — Bayesian Information Criteria.
Pearson X 2 goodness-of-fit test, P , 0.001.
the skin and cause necrosis (17) rather than being the serious
sequela of ear necrosis. However, bloody ear lesions are likely
to attract penmates whose chewing could result in the severity
of the lesions (18). Therefore, further research on whether ear
necrosis leads to biting or biting is a prerequisite for ear necrosis
is warranted since the results of such a study would assist the
current effort towards the control of ear necrosis.
High humidity was also a risk factor for ear necrosis in the
present study which is in agreement with other reports (4,12).
This is consistent with bacterial etiology since high humidity
may facilitate the buildup of staphylococci or other pathogens.
However the assessment of the air quality and whether the barn
was humid in this study was subjective. In addition, humid-
ity in a pig barn is highly variable because it is influenced by
weather, season, and even activities in the barn such as washing.
Therefore this association of high humidity and ear necrosis
needs to be considered with caution. Case farms reported an
earlier weaning age than control farms and this finding is in
agreement with a previous study (13). It has been suggested
that when pigs are weaned at an early age they are more apt to
engage in behavioral vices such as chewing on penmates and
possibly causing mild skin damage; therefore, weaning age could
be associated with ear necrosis. The small number of farms used
in this study makes it difficult to clearly identify management
and environmental risk factors and is a significant weakness of
the study.
There were numerous sources of semen, replacement of gilts,
and different breeds of sows among the farms in this study. Pigs
with floppy ears have been suggested to be more prone to ear
biting and possibly more vulnerable to necrosis compared to
pigs with upright ears (17). However no such association was
noted in this study.
In conclusion, this study provides evidence that ear necrosis
is possibly an infectious disease beginning with lesions on the
outer skin surface. Spirochetes are not likely a primary cause
since they were only occasionally observed during histological
examination. Staphylococcus species should be considered to be
potential causative agents since they were commonly isolated
from ear lesions and the histological description of the lesions
are similar to exudative epidermitis which is a disease caused
by Staphylococcus species. However at this stage the role of
Staphylococcus species is speculative. Further research is neces-
CVJ / VOL 54 / MAY 2013
sary to investigate the isolates from cases of ear necrosis and
determine the presence of exfoliative toxins. Ear necrosis is
in all likelihood a disease that requires multiple contributing
factors. A study involving large numbers of case and control
farms is required to thoroughly investigate management and
environmental factors but in this small study high humidity,
early weaning, and the presence of ear biting appeared to be
A R T I C LE
associated with the condition.
Acknowledgments
The research was funded by Ontario Pork, the Animal Health
Strategic Investment Fund, Ontario Ministry of Agriculture,
Food and Rural Affairs, and the University of Guelph. We are
very appreciative of the farmers who participated and Bryan
Bloomfield for technical assistance. CVJ
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