Necrotizing Fasciitis of the Breast: A Case Report and Review of Literature

Abstract

Necrotizing fasciitis of the breast is a rare entity in surgical practice. Since the first report by Shah et al in 2001, only a few cases have been reported worldwide. The rarity of this condition is attested by the fact that there is no definite approach to diagnosis and treatment till date. The etio-pathogenesis is found to be multifactorial. Clinical course in progressive with huge potential for morbidity and mortality due to sepsis. A 35-years old housewife was referred to our center with 3-weeks history of a progressively enlarging swelling in her right breast. A breast abscess was clinically diagnosed, for which she underwent incision and drainage at a peripheral health center. However, she further developed a large chronic ulcer due to necrosis of the adjacent skin and was subsequently referred to our center. We managed our case through regular surgical debridement under antibiotic cover and successfully salvaged the breast. Delayed recognition, associated with massive local tissue destruction and systemic toxicity, remains a deadly pitfall in the management of necrotizing fasciitis. Various treatment modalities have been described for this condition, however, an early diagnosis is paramount and a timely aggressive intervention may save the patient’s life with good functional outcomes- a stitch in time saves nine.