{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:20:14Z","timestamp":1787869214226,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Necrotizing fasciitis (NF) is a rapidly progressive life-threatening infection involving necrosis of subcutaneous tissues and fascia. Though it mainly affects the extremities, perineum and abdominal wall, it rarely affects the breast.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 30-year-old woman on postpartum day seven presented with one-day history of fever with chills and rigors and painful, swollen and tender left breast. Although the initial diagnosis was mastitis, the disease progressively worsened with the breast developing ischaemic necrotic areas in the lower quadrants and nipple areolar region. Therefore, a clinical diagnosis of breast necrotizing fasciitis was made. She was managed with broad-spectrum antibiotics, hypertonic saline dressings and supportive care and debridement. Cultures from wound swabs showed multi-resistant polymicrobial growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Necrotizing fasciitis of the breast is mainly reported following pregnancy like in our patient. The diagnosis is mainly clinical with the help of laboratory and radiological investigations. Broad spectrum IV antibiotics, surgical\/chemical debridement, VAC dressings and supportive care are the main principles of managing necrotizing fasciitis. Alongside this, psychological support was crucial in the management of our patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We have reported rare presentation of a breastfeeding mother presenting with NF. We were able to successfully manage due to early identification and appropriate management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.110831","type":"journal-article","created":{"date-parts":[[2025,1,5]],"date-time":"2025-01-05T01:41:52Z","timestamp":1736041312000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Necrotizing fasciitis of the breast in a breastfeeding mother: A case report"],"prefix":"10.1097","volume":"127","author":[{"given":"Umayanga","family":"Sandaruwan","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasun","family":"Lakmal","sequence":"additional","affiliation":[{"name":"University Surgical Unit, Colombo South Teaching Hospital, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasthaka","family":"Dissanayake","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepalika","family":"Wijekoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanchana","family":"Wijesinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aloka","family":"Pathirana","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"1","key":"R1-26-20260325","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/23320885.2017.1364970","article-title":"Necrotizing fasciitis of the breast managed by partial mastectomy and local tissue rearrangement","volume":"4","author":"Konik,","year":"2017","journal-title":"Case Reports in Plastic Surgery and Hand Surgery."},{"key":"R2-26-20260325","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/1370680","article-title":"Necrotizing fasciitis of the breast: case report with literature review","volume":"2018","author":"ALShareef","year":"2018","journal-title":"Case reports in Surgery"},{"issue":"3","key":"R3-26-20260325","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/j.1524-4741.2009.00731.x","article-title":"Shared management of a rare necrotizing soft tissue infection of the breast","volume":"15","author":"Keune,","year":"2009","journal-title":"Breast J."},{"key":"R4-26-20260325","article-title":"Breast necrotising fasciitis managed by partial mastectomy.","volume":"2012","author":"Kaczynski","year":"2012","journal-title":"Case Reports."},{"key":"R5-26-20260325","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.ijscr.2017.01.049","article-title":"A case report of primary necrotising fasciitis of the breast: a rare but deadly entity requiring rapid surgical management","volume":"31","author":"Fayman,","year":"2017","journal-title":"Int. J. Surg. Case Rep."},{"issue":"1","key":"R6-26-20260325","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00404-008-0642-3","article-title":"Gas gangrene of the breast: management of a potential life-threatening infection","volume":"279","author":"Delotte,","year":"2009","journal-title":"Arch. Gynecol. Obstet."},{"issue":"5","key":"R7-26-20260325","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi,","year":"2023","journal-title":"Int. J. Surg."},{"key":"R8-26-20260325","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2022.107844","article-title":"Primary necrotizing fasciitis of the breast in a young patient, a case report","volume":"102","author":"Molla,","year":"2023","journal-title":"Int. J. Surg. Case Rep."},{"key":"R9-26-20260325","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2023.109147","article-title":"Uncommon presentation of necrotizing fasciitis affecting the breast in a young breastfeeding patient: case report","volume":"114","author":"Benlghazi,","year":"2024","journal-title":"Int. J. Surg. Case Rep."},{"issue":"1","key":"R10-26-20260325","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1054\/bjps.2000.3461","article-title":"Necrotising fasciitis of the breast","volume":"54","author":"Shah,","year":"2001","journal-title":"Br. J. Plast. Surg."},{"key":"R11-26-20260325","doi-asserted-by":"crossref","first-page":"16","DOI":"10.9790\/0853-1151618","article-title":"Necrotizing fasciitis of the breast a rare presentation in postpartum mother","volume":"11","author":"Pote,","year":"2013","journal-title":"IOSR Journal of Dental and Medical Sciences"},{"issue":"2","key":"R12-26-20260325","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jiac.2014.08.031","article-title":"Streptococcal toxic shock syndrome from necrotizing soft-tissue infection of the breast caused by a mucoid type strain","volume":"21","author":"Kohayagawa,","year":"2015","journal-title":"J. Infect. Chemother."},{"issue":"11","key":"R13-26-20260325","doi-asserted-by":"crossref","first-page":"775","DOI":"10.12968\/jowc.2019.28.11.775","article-title":"Post-traumatic necrotising fasciitis of the breast: a case study with literature review","volume":"28","author":"Gupta","year":"2019","journal-title":"J. Wound Care"},{"issue":"3","key":"R14-26-20260325","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/004947559802800320","article-title":"Idiopathic partial gangrene of the breast","volume":"28","author":"Sahoo,","year":"1998","journal-title":"Trop. Doct."},{"issue":"2","key":"R15-26-20260325","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1524-4741.2009.00697.x","article-title":"First report of a necrotising fasciitis of the breast following a core needle biopsy","volume":"15","author":"Flandrin,","year":"2009","journal-title":"Breast J."},{"issue":"6","key":"R16-26-20260325","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1749-7922-6-29","article-title":"Breast gangrene","volume":"19","author":"Wani,","year":"2011","journal-title":"World J. Emerg. Surg."},{"issue":"1","key":"R17-26-20260325","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1075-122X.2006.00186.x","article-title":"Necrotizing fasciitis in a postmastectomy wound","volume":"12","author":"Velchuru,","year":"2006","journal-title":"Breast J."},{"issue":"1","key":"R18-26-20260325","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s12282-010-0219-4","article-title":"Bilateral necrotizing fasciitis of the breast following quadrantectomy","volume":"21","author":"Angarita,","year":"2014","journal-title":"Breast Cancer"},{"issue":"2","key":"R19-26-20260325","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1524-4741.2007.00556.x","article-title":"Necrotizing fasciitis following modified radical mastectomy","volume":"14","author":"Gehlen,","year":"2008","journal-title":"Breast J."},{"issue":"5","key":"R20-26-20260325","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/0002-9610(66)90051-1","article-title":"Necrosis of the breast: a rare complication of anticoagulant therapy","volume":"111","author":"Nudelman,","year":"1966","journal-title":"Am. J. Surg."},{"issue":"12","key":"R21-26-20260325","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1001\/archsurg.137.12.1441","article-title":"Breast gangrene as a complication of puerperal sepsis.","volume":"137","author":"Rege","year":"2002","journal-title":"Arch. Surg."},{"key":"R22-26-20260325","first-page":"313","article-title":"Mammary infarcts associated with pregnancy presenting as breast tumors","volume":"49","author":"Hasson,","year":"1961","journal-title":"Surgery"},{"issue":"3","key":"R23-26-20260325","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/aji.12322","article-title":"Immune changes and dysphoric moods across the postpartum","volume":"73","author":"Groer,","year":"2015","journal-title":"Am. J. Reprod. Immunol."},{"issue":"6","key":"R24-26-20260325","doi-asserted-by":"crossref","first-page":"369","DOI":"10.2165\/00002018-199717060-00003","article-title":"Nonsteroidal anti-inflammatory drugs and necrotising fasciitis","volume":"17","author":"Holder,","year":"1997","journal-title":"An update. Drug Saf."},{"issue":"7","key":"R25-26-20260325","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/01.CCM.0000129486.35458.7D","article-title":"The LRINEC (laboratory risk Indicator for necrotizing fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections","volume":"32","author":"Wong,","year":"2004","journal-title":"Crit. Care Med."},{"issue":"1","key":"R26-26-20260325","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.suc.2013.10.011","article-title":"Necrotizing skin and soft tissue infections","volume":"94","author":"Kaafarani,","year":"2014","journal-title":"Surg. Clin. N. Am."},{"issue":"4","key":"R27-26-20260325","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1089\/sur.2020.071","article-title":"Necrotizing fasciitis of the breast: a review of the literature","volume":"22","author":"Cai,","year":"2021","journal-title":"Surg. Infect. (Larchmt.)"},{"issue":"8","key":"R28-26-20260325","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/jcu.20492","article-title":"Sonographic findings of necrotizing fasciitis in the breast","volume":"36","author":"Hanif,","year":"2008","journal-title":"J of Clinical Ultrasound."},{"issue":"2","key":"R29-26-20260325","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/jan.12832","article-title":"Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties","volume":"72","author":"Brown,","year":"2016","journal-title":"J. Adv. Nurs."},{"issue":"12","key":"R30-26-20260325","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1471-2393-12-36","article-title":"Breastfeeding cessation and symptoms of anxiety and depression: a longitudinal cohort study","volume":"23","author":"Ystrom,","year":"2012","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225000173?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225000173?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.110831","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:24:02Z","timestamp":1774434242000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.110831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":30,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2025.110831","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-10-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}