Necrotizing fasciitis of the breast after bilateral breast reduction

Abstract

Abstract Necrotizing fasciitis is a rare infection that rapidly progresses through fascial planes. Due to the latter, diagnosis in a timely manner is imperative to ultimately decrease morbidity and mortality. Such a disease process can occur anywhere in the body; however, necrotizing fasciitis of the breast is extremely rare and not well documented in the available literature. This is a case report about a 49-year-old woman who developed severe necrotizing fasciitis of both breasts following elective bilateral breast reduction. The patient developed a severe soft tissue infection leading to destruction of local tissue and required management in a surgical high dependency unit. This case report outlines the immediate management and the ensuing steps in reconstruction. Necrotizing fasciitis of the breast is a rare complication of breast reduction surgery. Early recognition and aggressive treatment with broad-spectrum antibiotics, hyperbaric therapy and repeated debridement are essential for successful management. The use of Integra Bilayer Wound Matrix and skin grafting can result in satisfactory outcomes. It is important to obtain tissue samples for culture and sensitivity testing to identify the offending organism in patients with suspected necrotizing fasciitis. This case report highlights the importance of early diagnosis and management of necrotizing fasciitis to prevent morbidity and mortality.