Woman was diagnosed with Necrotizing Fasciitis of breast and chest wall; doctor said bacterial infection of bone in middle of chest following a breast abscess is unheard of
Rebeiro needed a multimodal treatment strategy—surgery and long-term antibiotic injections. Representation pic
A 49-year-old Thane resident was successfully treated for a rare life-threatening bacterial breast infection and returned home.
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Flavy Rebeiro first noticed a painful swelling on the left side of her breast in April. “Her blood sugar levels also shot up. We took her to a local hospital where she underwent her first surgery in May,” said Fredrick, her husband. Though the surgery drained out the abscess, the infection persisted and spread.
“The local doctor then asked us to take her to some other hospital as they were unable to treat her,” said Fredrick.
She was then brought to SL Raheja Hospital, Mahim where she was diagnosed with Necrotizing Fasciitis of breast and chest wall.
Doctors at SL Raheja Hospital said Rebeiro was also a case of undetected and uncontrolled diabetes. “In this case, uncontrolled diabetes paved the path for the spread of infection. A CT scan of the chest revealed osteomyelitis (bacterial or fungal infection of the bone) of the sternum and adjacent ribs,” said Dr Leena Jain, plastic and reconstructive microsurgeon, adding that bacterial or fungal infection of the bone located in the middle of chest following a breast abscess is unheard of. She said there are a very few such cases reported in medical literature and a rare entity.
Dr Jain said there was a chance of the infection spreading to Rebeiro’s lungs or lining of the heart, which could have been fatal. “She needed a multimodal treatment strategy—surgery and long-term antibiotic injections. In her case, we brought her sugar level under control, followed by a debridement surgery to remove all non-viable tissues—six costal cartilages on each side were removed. The cartilages broke like chalk pieces. However, the breastbone seemed clinically healthy,” she said.
Cultures from the wound showed Klebsiella—a type of Gram-negative bacteria which is known to cause notorious infections including Pneumonia. After the procedures, a large wound of 18cmx12cm remained in the middle of Rebeiro’s chest wall with the lining of lungs and heart covered with a flimsy layer of tissue which was covered with a flap taken from her back.
Rebeiro is now home on a six-week antibiotic injection course to ensure complete eradication of the bone infection.
18cmx12cm
Size of wound in Rebeiro’s chest wall after operation
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