Puerperal Mastitis Presenting with Extensive Skin Necrosis: Case Report

Puerperal mastitis occurs in approximately one third of the lactating women. It often has mild and localized clinical presentation, which can be easily treated by changing breastfeeding technique, breast massage, or simple antibiotics. However, lactation mastitis rarely presents as extensive necrotizing disease. In this paper, we report a case of an extensive necrotizing mastitis in a 23-year-old healthy woman, which presented ten days postpartum. Extensive debridement was avoided not to cause a large mammarian tissue loss, therefore she was mainly treated by wound care with topical nitrofurazone regularly for one month. Although this serious condition was reported to be associated with several accompanying systemic disorders such as diabetes mellitus and autoimmune vasculitis, it can also develop in healthy breastfeeding women. Differential diagnosis includes inflammatory breast carcinoma and granulomatous mastitis. The treatment should be based on the extention of the disease, particularly in case of the necrotizing mastitis limited to skin.