Kamagate Nadia, DeVito Robert
Western Reserve Health Education Trumbull Regional Medical Center, Department of Surgery, 1350 East Market Street Warren, Ohio, USA.
Northeast Ohio Medical University, 4209 St. OH-44 Rootstown, Ohio 44272, USA.
Case Rep Surg. 2020 Dec 11;2020:8876475. doi: 10.1155/2020/8876475. eCollection 2020.
Necrotizing soft tissue infection has been historically recognized as a severe, rapidly spreading soft tissue infection associated with a very high risk of mortality. Cases of primary necrotizing fasciitis of the breast are rarely described but often fatal. We present a case of necrotizing soft tissue infection of the right breast extending to the anterior abdominal wall in a 39-year-old obese female, with a history of tobacco use. The patient presented 10 days after symptom onset due to concerns and anxiety related to COVID-19 exposure. This delay allowed for further extension and smoldering of the breast infection. The treatment of this aggressive disease process begins with early diagnosis, where a high index of suspicion is vital. Once diagnosed, the treatment regimen should be composed of emergent surgical debridement, which can include breast salvage debridement or total mastectomy, in addition to antibiotic therapy.
坏死性软组织感染一直以来都被视为一种严重的、迅速蔓延的软组织感染,其死亡率极高。乳腺原发性坏死性筋膜炎的病例鲜有报道,但往往是致命的。我们报告一例39岁肥胖女性,有吸烟史,其右乳腺坏死性软组织感染蔓延至前腹壁。患者因担心与接触新冠病毒相关而在症状出现10天后才就诊。这种延误使得乳腺感染进一步扩散并持续发展。对于这种侵袭性疾病过程的治疗始于早期诊断,高度的怀疑指数至关重要。一旦确诊,治疗方案应包括紧急手术清创,这可能包括保留乳房的清创术或全乳房切除术,此外还需进行抗生素治疗。