Necrotizing fasciitis of the breast in a breastfeeding mother: A case report

Necrotizing fasciitis (NF) is a rapidly progressive life-threatening infection involving necrosis of subcutaneous tissues and fascia. Though it mainly affects the extremities, perineum and abdominal wall, it rarely affects the breast.

A 30-year-old woman on postpartum day seven presented with one-day history of fever with chills and rigors and painful, swollen and tender left breast. Although the initial diagnosis was mastitis, the disease progressively worsened with the breast developing ischaemic necrotic areas in the lower quadrants and nipple areolar region. Therefore, a clinical diagnosis of breast necrotizing fasciitis was made. She was managed with broad-spectrum antibiotics, hypertonic saline dressings and supportive care and debridement. Cultures from wound swabs showed multi-resistant polymicrobial growth.

Necrotizing fasciitis of the breast is mainly reported following pregnancy like in our patient. The diagnosis is mainly clinical with the help of laboratory and radiological investigations. Broad spectrum IV antibiotics, surgical/chemical debridement, VAC dressings and supportive care are the main principles of managing necrotizing fasciitis. Alongside this, psychological support was crucial in the management of our patient.

We have reported rare presentation of a breastfeeding mother presenting with NF. We were able to successfully manage due to early identification and appropriate management.