A mother was deeply alarmed when one of her breasts turned black due to skin necrosis shortly after giving birth prematurely at 22 weeks. Within 15 days postpartum, the 38-year-old woman noticed a black spot on her breast.
Concerned about the symptoms, she sought medical attention, and doctors diagnosed her with mastalgia, characterized by breast pain that can be heavy, tender, or burning. Additionally, she experienced erythema, indicating skin redness, and general malaise, a vague sense of discomfort or illness.
Despite not breastfeeding but using a breast pump, the patient had no history of breast problems, diabetes, or smoking. An ultrasound revealed no abscess or fluid in her breast. She was prescribed antibiotics (flucloxacillin) when the bruising worsened significantly over two days, prompting fears of necrotising fasciitis, a severe bacterial infection that rapidly damages skin, fat, and connective tissue.
Tests showed her breast milk contained MRSA, a resistant bacteria strain. A surgical consultant determined the presence of group A streptococcus (GAS) erysipelas, a bacterial skin infection. Treatment involved antibiotics for both infections and potential necrotising fasciitis.
After five days in the hospital, she was discharged but later developed dry necrosis, leading to tissue death due to inadequate blood supply. Subsequent examinations confirmed necrotic erysipelas, an uncommon and severe form of the condition. Surgical intervention was necessary to remove dead tissue, followed by multiple debridement procedures until the wound healed and stopped leaking milk.
A month post-surgery, she underwent skin grafting, which successfully healed the wound. Subsequently, she was discharged from further follow-up care, with no ongoing issues. This extraordinary case was documented in a medical journal.
