Necrotizing soft tissue infection of the breast: Case report and literature review

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dc.contributor.authorVieira, René Aloisio Da Costa
dc.contributor.authorMatthes, Angelo Gustavo Zucca [UNESP]
dc.contributor.authorMichelli, Rodrigo Augusto Depieri
dc.contributor.authorRibeiro, Gustavo Henrique Fabri Pereira
dc.contributor.authorHaikel, Raphael Luiz
dc.contributor.authorViana, Cristiano Ribeiro
dc.contributor.authorCastro, Paulo de Tarso Oliveira
dc.contributor.authorUemura, Gilberto [UNESP]
dc.contributor.institutionHospital do Câncer de Barretos
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:26:53Z
dc.date.available2014-05-27T11:26:53Z
dc.date.issued2012-08-01
dc.description.abstractBackground: Necrotizing soft tissue infection (NSTI) is characterized by progressive infectious gangrene of the skin and subcutaneous tissue. Its treatment involves intensive care, broad-spectrum antibiotic therapy, and full debridement. Methods: We present two cases of NSTI of the breast, adding these cases to the 14 described in the literature, reviewing the characteristics and evolution of all cases. Case Report: On the fourth day after mastectomy, a 59-year-old woman with ulcerated breast cancer developed Type I NSTI caused by Pseudomonas aeruginosa, which had a favorable evolution after debridement and broad-spectrum antibiotics. The second patient was a 57-year-old woman submitted to a mastectomy and axillary dissection, who had recurrent seromas. On the 32nd post-operative day, after a seroma puncture, she developed Type II NSTI caused by β-hemolytic streptococci. She developed sepsis and died on the tenth day after debridement, intensive care, and broad-spectrum antibiotics. The cases are the first description of breast NSTI after mammary seroma aspiration and the first report of this condition caused by P. aeruginosa. Conclusion: Necrotizing soft tissue infection is rare in breast tissue. It frequently is of Type II, occurring mainly after procedures in patients with breast cancer. The surgeon's participation in controlling the focus of the infection is of fundamental importance, and just as important are broad-spectrum antibiotic therapy and support measures, such as maintenance of volume, correction of electrolytic disorders, and treatment of sepsis and septic shock. Once the infection has been brought under control, skin grafting or soft tissue flaps can be considered. The mortality rate in breast NSTI is 18.7%, all deaths being in patients with the fulminant Type II form. Surgical oncologists need to be alert to the possibility of this rare condition. © 2012, Mary Ann Liebert, Inc.en
dc.description.affiliationDepartment of Surgical Oncology Barretos Cancer Hospital, Barretos
dc.description.affiliationDepartment of Pathology Barretos Cancer Hospital, Barretos
dc.description.affiliationInfectious Diseases Barretos Cancer Hospital, Barretos
dc.description.affiliationDepartment of Gynecology, Obstetrics and Mastology Botucatu School of Medicine, Botucatu
dc.format.extent270-275
dc.identifierhttp://dx.doi.org/10.1089/sur.2011.029
dc.identifier.citationSurgical Infections, v. 13, n. 4, p. 270-275, 2012.
dc.identifier.doi10.1089/sur.2011.029
dc.identifier.issn1096-2964
dc.identifier.issn1557-8674
dc.identifier.lattes9878648143577124
dc.identifier.scopus2-s2.0-84866975833
dc.identifier.urihttp://hdl.handle.net/11449/73462
dc.language.isoeng
dc.relation.ispartofSurgical Infections
dc.relation.ispartofjcr1.689
dc.relation.ispartofsjr0,711
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectamikacin
dc.subjectamoxicillin
dc.subjectampicillin
dc.subjectcefazolin
dc.subjectcefepime
dc.subjectceftriaxone
dc.subjectchlormidazole
dc.subjectclavulanic acid
dc.subjectclindamycin
dc.subjectertapenem
dc.subjectgentamicin
dc.subjectlinezolid
dc.subjectmetronidazole
dc.subjecttazobactam
dc.subjecttobramycin
dc.subjectvancomycin
dc.subjectadult
dc.subjectantibiotic therapy
dc.subjectaspiration
dc.subjectbeta hemolytic Streptococcus
dc.subjectbreast carcinoma
dc.subjectcancer adjuvant therapy
dc.subjectcase report
dc.subjectdebridement
dc.subjectelectrolyte disturbance
dc.subjectfemale
dc.subjecthuman
dc.subjectinfection control
dc.subjectintensive care
dc.subjectmastectomy
dc.subjectmastitis
dc.subjectmedical specialist
dc.subjectmortality
dc.subjectpostoperative care
dc.subjectpriority journal
dc.subjectPseudomonas aeruginosa
dc.subjectrecurrent disease
dc.subjectsepsis
dc.subjectseptic shock
dc.subjectseroma
dc.subjectskin graft
dc.subjectsoft tissue infection
dc.subjecttissue flap
dc.subjectBacteremia
dc.subjectBreast Neoplasms
dc.subjectFasciitis, Necrotizing
dc.subjectFatal Outcome
dc.subjectFemale
dc.subjectHumans
dc.subjectMastectomy
dc.subjectMiddle Aged
dc.subjectPseudomonas Infections
dc.subjectSoft Tissue Infections
dc.subjectStreptococcus pyogenes
dc.titleNecrotizing soft tissue infection of the breast: Case report and literature reviewen
dc.typeArtigo
dcterms.licensehttp://www.liebertpub.com/nv/resources-tools/self-archiving-policy/51/
unesp.author.lattes9878648143577124
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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