Year: 2026 | Month: May | Volume: 13 | Issue: 5 | Pages: 784-788
DOI: https://doi.org/10.52403/ijrr.20260577
From Benign to Brutal: A Breast Infection Gone Rogue - A Case of Necrotizing Fasciitis of the Breast
Dr. MD Mustafa1, Dr. Manjunath H.R1, Dr. Lakshminarayan1, Dr. Kalavathi1, Dr. Anil1
1Department of General Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, India
Corresponding Author: Dr. MD Mustafa
ABSTRACT
Background: Necrotizing fasciitis (NF) of the breast is an exceedingly rare, rapidly progressive, and potentially life-threatening soft tissue infection involving the subcutaneous tissue, superficial fascia, and overlying skin. It represents a true surgical emergency with high morbidity and mortality if not recognized and managed promptly.
Case Summary: We report a case of a 65-year-old female presenting with a one-month history of progressive pain and swelling of the right breast. Clinical examination revealed a 3×4 cm wound in the upper outer quadrant with foul-smelling discharge, slough, and surrounding fluid-filled blebs with crepitus. Laboratory investigations demonstrated leukocytosis (TLC 21,850 cells/µL) with neutrophilia (94%), elevated serum sodium (159 mmol/L), serum creatinine (3.3 mg/dL), decreased hemoglobin (9.8g/dl) and elevated CRP (201mg/L) with Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score of 11. Gram staining identified Gram-negative organisms. The patient underwent emergency surgical debridement followed by mastectomy and reconstruction using a split thickness skin grafting.
Conclusion: Early clinical suspicion, prompt microbiological evaluation, and aggressive surgical management are critical to favourable outcomes in NF of the breast. The LRINEC score serves as a valuable adjunct in diagnosis. Staged surgical management comprising emergency debridement, mastectomy, and split thickness skin grafting surgery resulted in a satisfactory outcome in our case.
Keywords: Necrotizing fasciitis, breast, LRINEC score, surgical debridement, mastectomy, split thickness skin grafting, soft tissue infection
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