Primary necrotizing fasciitis of the breast in a young patient, a case report

BACKGROUND: Necrotizing fasciitis is a life-threatening and potentially fatal condition which commonly affects extremities, abdominal wall and perineum. However, it can affect any body part. Breasts are very rarely affected, with most of the cases are following surgical intervention or trauma. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure. Here we present necrotizing fasciitis of the breast in a 28-year-old female patient with no identified risk factor. CLINICAL PRESENTATION: A 28-year-old woman on her 4th month of lactation presented to the emergency department with a 4-day history of right breast pain and swelling. Associated with this, she had darkening of the skin of the right breast, high-grade fever, and foul-smelling discharge from the wound. On examination, she was febrile, tachycardic and hypotensive. Breast examination showed signs suggestive of NF. Subsequently, the patient was managed with broad spectrum antibiotics, supportive care, surgical debridement followed by partial mastectomy and finally the patient was discharged improved. CONCLUSION: Although it is a rare phenomenon, necrotizing soft-tissue infections of the breast can progress rapidly and carry a high mortality rate. Therefore, early diagnosis and immediate surgical intervention are of paramount importance. Here, we aim to show the importance of early diagnosis and the need for appropriate therapy to avoid complications and death.