A woman who recently became a mother was shocked when one of her breasts turned black due to skin death. The 38-year-old first noticed a dark mark on her breast just 15 days after delivering a premature baby at 22 weeks gestation.
Experiencing troubling symptoms, she sought medical attention, and doctors identified her condition as mastalgia, a type of breast pain characterized by heaviness, tenderness, or burning sensation. Additionally, she exhibited erythema, indicating skin redness, and general malaise, a vague feeling of discomfort or sickness.
Despite not breastfeeding but using a breast pump, the patient had no history of breast problems, diabetes, or smoking. An ultrasound showed no abscess or fluid in her breast, and she was prescribed antibiotics (flucloxacillin). However, within two days, the bruising on her breast worsened significantly, raising concerns about necrotising fasciitis, a severe bacterial infection that rapidly destroys skin, fat, and connective tissue.
Further tests revealed the presence of MRSA, a drug-resistant bacteria, in her breast milk. A surgical specialist determined that the condition likely stemmed from group A streptococcus (GAS) erysipelas, a bacterial skin infection. She received antibiotics to target both infections and potential necrotising fasciitis.
Fortunately, the woman’s condition stabilized, and she was discharged after five days, continuing treatment at home. Nevertheless, two weeks later, she developed dry necrosis, characterized by tissue death due to inadequate blood supply. Her wound exhibited dead tissue and fluid, with milk seeping from it.
Doctors diagnosed her with necrotic erysipelas, an uncommon and severe form of erysipelas resulting in skin death. She underwent surgical removal of the dead tissue and received a vacuum closure dressing. Subsequent debridement procedures were required until the wound healed and stopped leaking milk.
Following her initial operation, she underwent skin grafting, which led to successful wound healing and discharge from follow-up care. She has since remained in good health without any further complications. This extraordinary case was documented in a medical journal.