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A new mum was left horrified after one of her breasts turned black as her skin died. The 38-year-old noticed a black mark on her breast just 15 days after giving birth to a preterm baby at 22 weeks.
After a day of worrying symptoms, she went to hospital, where doctors diagnosed her with mastalgia – breast pain that can feel heavy, tender or burning – along with erythema, meaning redness of the skin, and general malaise, a nonspecific feeling of discomfort or illness.
At the time, the patient was not breastfeeding but was pumping, which may have made her breast more vulnerable to infection. She had no previous breast issues, no diabetes, and was a non-smoker.
A breast ultrasound found no abscess or fluid, and she was started on antibiotics (flucloxacillin). But over the next two days, the bruising on her breast worsened dramatically. Doctors became concerned about necrotising fasciitis, a severe, fast-spreading bacterial infection that destroys skin, fat, and connective tissue.
Tests showed her breast milk contained MRSA, a resistant strain of bacteria. A surgical consultant reviewed her case and concluded the appearance was most consistent with group A streptococcus (GAS) erysipelas – a bacterial skin infection. She was treated with antibiotics to cover both infections and possible necrotising fasciitis.
Thankfully, she remained stable and was discharged on day five, continuing treatment at home. However, two weeks later, she developed dry necrosis – when tissue dies due to lack of blood supply. Her wound showed dead tissue and fluid, with some milk leaking from it.
Doctors confirmed necrotic erysipelas, a rare and severe form of erysipelas where part of the skin dies. She underwent surgery to remove the dead tissue and had a vacuum closure dressing applied. The mum needed three further debridement procedures until the wound was healthy and no longer leaking milk.
One month after her first operation, she underwent skin grafting. Her wound healed well, and she was discharged from follow-up care.
She remains well with no further problems. The shcking case was reported in a medical journal.