A case of necrotizing fasciitis of the breast following lumpectomy and oncoplastic closure.

IF 17.7 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-01-01 DOI:10.25270/wnds/23129
L. Berger, Daisy L. Spoer, Samuel S. Huffman, Eleanor Drew, I. Greenwalt, Kenneth L. Fan
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Abstract

BACKGROUND NF is a life-threatening soft tissue infection that most commonly occurs in the lower extremity. While presenting symptoms such as erythema, severe pain, sepsis, and wound crepitation are well documented, diagnosis of NF of the breast often is obscured by a low clinical index of suspicion due to its relative rarity as well as by the breast parenchyma that physically separates the underlying fascia and overlying skin. Several risk factors have previously been identified, such as underlying infection, diabetes, advanced age, and immunosuppression. However, the gross morbidity and high mortality associated with NF warrant continued surveillance of contributing factors across any anatomic location. Fifteen cases in the literature document the development of NF following breast surgery. CASE REPORT The authors of this case report aim to expand on the current literature through the presentation of a unique case of NF of the breast following right breast lumpectomy and oncoplastic closure with left reduction mammaplasty in an immunocompromised patient found to have concurrent perforated sigmoid diverticulitis. CONCLUSION This case exemplifies how frequent postoperative surveillance, a low threshold for intervention, and efficient coordination of care are vital to minimizing the morbidity and mortality risks associated with NF of the breast.
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一例肿块切除术和肿瘤整形缝合术后的乳腺坏死性筋膜炎病例。
背景NF是一种危及生命的软组织感染,最常发生在下肢。虽然红斑、剧烈疼痛、败血症和伤口吱吱作响等症状已被充分记录,但由于其相对罕见,以及乳腺实质将下层筋膜和上覆皮肤物理性分隔,临床怀疑指数较低,因此乳腺 NF 的诊断往往被掩盖。以前曾发现过一些风险因素,如潜在感染、糖尿病、高龄和免疫抑制。然而,NF 的发病率和死亡率都很高,因此有必要继续监控任何解剖位置的诱发因素。本病例报告的作者旨在通过介绍一例独特的乳腺 NF 病例,对现有文献进行扩充。该病例发生在一名免疫力低下的患者身上,患者在接受右侧乳房肿块切除术和左侧乳房缩小整形术后,发现同时患有乙状结肠憩室炎穿孔。结论:本病例说明了频繁的术后监测、较低的干预门槛和有效的护理协调对于最大限度地降低与乳腺 NF 相关的发病率和死亡率风险至关重要。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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