Breast Necrotizing Fasciitis: Experience from a Resource-Limited Setting

Abstract

Introduction

Necrotizing fasciitis of the breast is an uncommon but life-threatening soft tissue infection that may occur following breast surgery or inadequately treated mastitis. Delayed diagnosis and treatment can result in extensive breast tissue and skin necrosis, severe sepsis, and significant morbidity. This paper describes the clinical presentation, management, and outcomes of breast necrotizing fasciitis in a resource-limited setting and highlight the challenges associated with its management.

Methods

This retrospective study reviewed the records of women managed for breast necrotizing fasciitis between January 2019 and December 2023. Demographic characteristics, clinical presentation, microbiological findings, treatment, complications, and outcomes were analysed using descriptive statistics.

Results

Twenty-six women with a mean age of 27 years were managed during the study period. Most were married, unemployed housewives, and developed necrotizing fasciitis secondary to lactational mastitis (73.1%). All patients presented with ulcerated breast swelling, foul-smelling discharge, and skin necrosis, while breast tissue necrosis occurred in 38.5%. Bilateral breast involvement was observed in 42.3% of patients. Staphylococcus aureus was the commonest organism isolated (34.6%). All patients underwent repeated surgical debridement, with mastectomy performed in five (19.2%) and split-thickness skin grafting in six (23.1%). The mean hospital stay was 22 days, and no mortality was recorded.

Conclusion

Breast necrotizing fasciitis is associated with considerable morbidity, particularly among young women of reproductive age. Early diagnosis, prompt surgical intervention, and appropriate supportive care are essential to minimise complications and improve outcomes.