Multidisciplinary management of necrotizing fasciitis as a postoperative complication after mastectomy in an adult male in a low- and middle-income country

TL;DR

A man in a low-income country developed a severe infection after breast cancer surgery, requiring complex multidisciplinary care due to financial barriers.

Contribution

Highlights the challenges of managing rare postoperative complications in resource-limited settings through a case report.

Findings

Necrotizing fasciitis occurred as a post-mastectomy complication in a male patient.

Financial constraints led to missed follow-ups and incomplete treatment, contributing to complications.

Multidisciplinary care was essential for managing both infection and cancer metastasis.

Abstract

Necrotizing fasciitis, a rare, potentially life-threatening infection, often necessitates urgent medical intervention and surgical excision of the affected tissue. We present a 55-year-old male patient with a progressively enlarging lump in the left breast that was diagnosed as a breast carcinoma. Post-modified radical mastectomy, histopathological examination revealed Grade II invasive ductal carcinoma with neuroendocrine features. Due to financial constraints, the patient missed post-operative follow-ups and did not complete the prescribed radiotherapy sessions. Three months later, the patient returned with fever, swelling alongside sharp pain in the left arm and oozing blood. A clinical diagnosis of necrotizing fasciitis was made, leading to urgent surgical debridement. While the wound progressively healed, a contracture developed restricting elbow movement. An Orthopedic Review and Bone scintigraphy revealed metastasis of breast carcinoma to the sternum. This case report highlights the multi-disciplinary management required in such financially constrained rare cases in low- and middle-income countries.

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