A new mother was shocked when one of her breasts turned black due to skin death shortly after giving birth prematurely. The 38-year-old woman noticed a black mark on her breast just 15 days after delivering her baby at 22 weeks gestation.
Experiencing worrying symptoms, she sought medical attention at a hospital, where doctors diagnosed her with mastalgia, characterized by breast pain that can feel heavy, tender, or burning, along with erythema (skin redness) and general malaise (a feeling of discomfort or illness).
Despite not breastfeeding, the patient was pumping milk, which might have increased her breast’s susceptibility to infection. She had no history of breast problems, diabetes, or smoking.
An ultrasound revealed no abscess or fluid in her breast, and she was prescribed antibiotics (flucloxacillin). However, the bruising on her breast worsened significantly over the following two days, raising concerns about necrotizing fasciitis, a severe bacterial infection that rapidly destroys skin, fat, and connective tissue.
Tests indicated the presence of MRSA, a resistant bacterial strain, in her breast milk. A surgical consultant determined that the most likely cause of her condition was group A streptococcus (GAS) erysipelas, a bacterial skin infection. She received antibiotic treatment targeting both infections and potential necrotizing fasciitis.
Fortunately, her condition stabilized, and she was discharged after five days with continued home treatment. Nevertheless, two weeks later, she developed dry necrosis, leading to tissue death due to inadequate blood supply. Her wound exhibited dead tissue and leaked milk.
Doctors diagnosed her with necrotic erysipelas, an uncommon and severe form of erysipelas resulting in skin death. She underwent surgery to remove the dead tissue and received a vacuum closure dressing. Subsequent debridement procedures were necessary until the wound healed, and milk leakage ceased.
Following her initial operation, she underwent skin grafting a month later. The wound healed successfully, and she was released from follow-up care.
The patient is currently in good health with no recurring issues. This remarkable case was documented in a medical journal.