Necrotizing fasciitis of the breast in Ahmadu Bello University Teaching Hospital, Zaria, Northwestern Nigeria

Abstract

Context: Necrotizing fasciitis of the breast is rare globally. There is an observed increase in the number of cases seen in our hospital. Moreover, there is no previous documentation on the disease from this center. Aims: The aim was to highlight the clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast. Settings and Design: It was a 5-year prospective study from January 2012 to December 2016. Subjects and Methods: The biodata, clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast were documented. Statistical Analysis Used: The results were analyzed using SPSS software version 21 and presented as percentages and charts. Results: Thirty-nine out of 163 women with infective breast disease had necrotizing fasciitis of the breast. Majority of the patients (28 [71.8%]) were <31 years. Most of the patients had low educational status (33 [84.6%]). The most common clinical features were foul-smelling discharging ulcers/sinuses and necrosis of the skin of the breast in all patients. Majority of the patients (29 [74.4%]) were lactating mothers. Poorly treated mastitis/breast abscess was the predominant predisposing factor. Culture revealed polymicrobial organisms in 20 (51.3%) patients. Thirty-six (92.3%) patients had serial wound debridement, 25 (64.1%) had split-thickness skin grafting, and 3 (7.7%) had toileting mastectomy. Mortality rate was 10.3%. Conclusions: Necrotizing fasciitis of the breast is not uncommon in our center. Majority of the patients were illiterate with low socioeconomic status. Poorly treated mastitis/breast abscess in lactating women was the major predisposing factor.