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

Uncommon presentation of necrotizing fasciitis affecting the breast in a young breastfeeding patient: Case report

“…NF initially defined by Wilson in 1952, is a rapidly progressive, life-threatening bacterial infection causing tissue necrosis along fascial planes [ 4 ].…”

“…Factors predisposing to NF include advanced age, alcoholism, obesity, chronic renal failure, cirrhosis, HIV, diabetes, hypertension, use of non-steroidal anti-inflammatory drugs, and immunosuppression (corticoids, chemotherapy, immunosuppressants). The post-partum period and breastfeeding are also risk factors due to weakened immunity [ 4 ].…”

“…Initial empiric broad-spectrum antibacterial therapy is recommended, covering Gram-positive, Gram-negative, and anaerobic organisms [ 4 ]. Antibiothrrapy should be adjusted according to the results of wound or blood cultures.…”

“…Smoking Right >3 1 Staphylococcus aureus , Klebsiella pneumoniae , and Acinetobacter baumanii . Staphylococcus epidermidis cefazolin gentamy- cin Yes Debridement Partial mastectomy VAC recovered RJ Klapper et al [ 25 ] 2022 68 Primary hypertension, hyperlipidemia, DM Right 5 1 Proteus species with gram stain positive for Gram-positive cocci vancomyci piperacillin-tazobactam NO Repeated debridement recovered YD Molla et al [ 4 ] 2023 28 Primary Breast feeding Right >2 NA None Ceftriaxone Metronidazol penicillin Yes Repeated debridement partial mastectomy recovered Our case 2023 26 Primary Breast feeding Right 9 1 Staphylococcus aureus , Klebsiella pneumoniae , and Acinetobacter baumanii . Ceftriaxone Metronidazole Gentamicin Yes debridement partial mastectomy Died of severe sepsis …”

“…In advanced cases of breast NF, total mastectomy is often performed to control the infection source. Various reconstruction options are available, including skin grafts, delayed closure, local tissue rearrangement, and flap reconstruction [ 4 ]. According to the study by Yuchen Cai, the mortality rate was 12.5 %( n = 40) [ 5 ].…”