Necrotizing Fasciitis of the Breast: A Review of the Literature

Cai, Yafei; Cai, Youquan; Shi, Wenjun; Feng, Qiuyun; Zhu, Ling

doi:10.1089/sur.2020.071

Cited by 16 publications

(23 citation statements)

References 52 publications

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“…Similar to our case, her history was significant for diabetes and hypertension [5]. In the literature, the reported cases have shown that predisposing risk factors can include hypertension, asthma, diabetes, steroid-dependent treatment, surgical incisions, abscess, mastitis, obesity, and smoking [5][6][7][8][9]. Meanwhile, the increased risk of developing NF of the breast is not yet associated with any particular age group.…”

Section: Discussionsupporting

confidence: 75%

“…Previously reported findings have shown mixed culture results from monomicrobial to polymicrobial incidents of NF. Cai et al studied a total of 40 cases from the literature and reported that around 37.5% were monomicrobial and related to Streptococcus pyogenes, whereas mixed organisms were found in 42.5% of the cases [9]. Our patient's culture returned with findings of Streptococcus anginosus, which is common in cases of cervical NF following pharyngeal or dental infection [10].…”

Section: Discussionmentioning

confidence: 58%

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Monomicrobial Necrotizing Fasciitis of the Breast: A Case Managed by Partial Mastectomy and Hydrogel Dressing

Mersil

Marzouk

Labeeb

2021

Cureus

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Necrotizing fasciitis (NF) is a rare life-threatening bacterial infection, which can be monomicrobial or polymicrobial, involving the fascia and eventually leading to necrosis. The course of the disease is rapidly progressive and can be misdiagnosed as an abscess or cellulitis. The disease requires more attention with respect to early diagnosis and treatment as it has a high mortality rate. In this report, we present the case of a 60-year-old female, who was a known case of hypertension and type 2 diabetes mellitus (T2DM). The patient presented to the emergency department on the 21st of October 2020, complaining of left breast pain for 10 days, which was associated with fever and nausea. On physical examination, the left breast was swollen and tender to palpation. There was a single patch of inflamed skin measuring 1 x 1 cm with greenish discoloration in the inframammary fold. Ultrasound of the breast showed a patch of focal mastitis with edema seen at 4-8 o'clock with no underlying fluid collection. She was admitted as a case of left breast abscess and was started on antibiotics. Despite the antibiotic therapy, the patient was still febrile and developed two more inflammatory and necrotic patches with no discharge. The patient underwent urgent surgical debridement of the necrotic tissues, leaving the wound packed for postoperative dressing. The patient stayed in isolation for a total of 25 days as she was found to be positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The surgical wound was closed, and the patient was discharged. Early diagnosis and management of NF is the key to saving the patient's life and improving outcomes.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 58%

Monomicrobial Necrotizing Fasciitis of the Breast: A Case Managed by Partial Mastectomy and Hydrogel Dressing

Mersil

Marzouk

Labeeb

2021

Cureus

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“…Split-thickness skin grafts (44.4%) and delayed primary closures (33.3%) were the most common methods of reconstruction. Septic shock at presentation was an independent risk factor for mortality (12.5%) in these patients (p<0.001) [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis of the Breast Requiring a Life-Saving Mastectomy: A Case Report and Literature Review

Islam¹,

Aziz²,

Shah³

et al. 2021

Cureus

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Necrotizing soft tissue infection of the breast is an extremely rare event in routine surgical practice. It is the most aggressive form of soft tissue infection and a real surgical emergency. It is associated with a high risk of mortality if not diagnosed promptly. A Literature search has revealed only a few such cases. The exact etiology is variable and very often multifactorial. Early recognition and prompt surgical treatment along with broad-spectrum antibiotic therapy are of paramount importance to prevent mortality. In this report, we present the first case of necrotizing fasciitis of the breast following an insect bite in the literature, in a 57year-old diabetic patient with a delayed presentation that required a life-saving mastectomy.

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“…Secondary necrotizing thoracic parietal fasciitis is most often reported due to pleurotomies or surgery for empyema, as in the present case. In fact, they are described secondary to any thoracic intervention, but more often secondary to extensive or esophageal resection, but also secondary to thoracocentesis or thoracic drainage in Boerhaave syndrome (1)(2)(3)24,25).…”

Section: Discussionmentioning

confidence: 99%

“…Most associated other anaerobic and aerobic flora, rarely being unimicrobial. Thus, in 76% of cases a polymicrobial flora was identified (2,(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Necrotizing fasciitis of the chest wall: A clinical case report and literature review

Petreanu¹,

Constantin

Iosifescu

et al. 2021

Exp Ther Med

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Necrotizing fasciitis of the chest wall is a very rare pathology, but with significant mortality, representing a therapeutic challenge. All international reports indicate the need for early diagnosis and an aggressive medical-surgical attitude in order to improve the prognosis. In addition to a review of literature, we present a case developed secondary to a thoracic pleural drainage for pyopneumothorax associated with significant bronchopleural fistula in a destroyed tuberculous left lung. Along with medical treatment, extensive surgical debridement was required. Despite drainage incisions and negative pressure wound therapy (NPWT), the evolution of the fasciitis was difficult, due to bronchopleurocutaneous fistula. Thus, the Azorin procedure (transcervical mediastinoscopic closure of the left main bronchus) was performed. Once this procedure was completed, the inflammatory phenomena were controlled which allowed for a second step consisting of left pneumonectomy, with the application of specific methods for the prevention of bronchial fistula. The clinical case was a therapeutic challenge requiring a complex, staged, multidisciplinary approach due to both the immunocompromised terrain and the severity of the lesions. In conclusion, early recognition and aggressive and combined application of medical and surgical treatment methods can ensure therapeutic success.

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Necrotizing Fasciitis of the Breast: A Review of the Literature

Cited by 16 publications

References 52 publications

Monomicrobial Necrotizing Fasciitis of the Breast: A Case Managed by Partial Mastectomy and Hydrogel Dressing

Monomicrobial Necrotizing Fasciitis of the Breast: A Case Managed by Partial Mastectomy and Hydrogel Dressing

Necrotizing Fasciitis of the Breast Requiring a Life-Saving Mastectomy: A Case Report and Literature Review

Necrotizing fasciitis of the chest wall: A clinical case report and literature review

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