A banal pain, an everyday gesture, and everything changes. For a young 38-year-old mother, what should have been a simple moment of bonding with her baby turned into an unexpected ordeal. Behind this rare case, Dr Gérald Kierzek, emergency doctor and medical director of True Medical, warns of a rare but formidable infection as it is capable of progressing in just a few hours.
“My chest turned black.” This rare infection almost cost him his life
After the premature birth of her baby, a 38-year-old woman experienced an unexpected nightmare. Fifteen days after giving birth, she noticed a black spot on her chest while she was expressing milk. Initially thinking it was just breast pain, she went to the hospital. Doctors diagnosed mastodynia and erythema.
© Jolley A, Murphy C. A rare case of necrotic erysipelas of the breast in a healthy, postpartum woman. J Surg Case Rep. 2025 Oct 7;2025(10):rjaf807. doi:10.1093/jscr/rjaf807. PMID: 41064027; PMCID: PMC12501110.
No abscess is visible on ultrasound, but despite antibiotics, the spot is expanding rapidly. Specialists then fear a necrotizing fasciitisa rare, blistering bacterial infection that destroys tissue under the skin.
© Jolley A, Murphy C. A rare case of necrotic erysipelas of the breast in a healthy, postpartum woman. J Surg Case Rep. 2025 Oct 7;2025(10):rjaf807. doi:10.1093/jscr/rjaf807. PMID: 41064027; PMCID: PMC12501110.
Analyzes revealed the presence of bacteria in her milk, and her condition required a series of surgical interventions. After several operations and a skin graft, the patient eventually recovered. This exceptional case illustrates the seriousness of an infection that is often overlooked by young mothers.
© Jolley A, Murphy C. A rare case of necrotic erysipelas of the breast in a healthy, postpartum woman. J Surg Case Rep. 2025 Oct 7;2025(10):rjaf807. doi:10.1093/jscr/rjaf807. PMID: 41064027; PMCID: PMC12501110.
What is necrotizing fasciitis and how can it appear?
Dr Gérald Kierzek explains this infection: “Necrotizing fasciitis is a very serious and rare bacterial infection that quickly destroys tissue under the skin. It is often caused by group A streptococci, sometimes associated with other germs“.
He specifies that “in a breastfeeding woman, it can develop from a poorly treated breast infection (mastitis or abscess), or following a microcrack in the nipple facilitating the entry of bacteria into the deep tissues“.
This infection can progress in just a few hours and “be life-threatening if not treated quickly“. The doctor also recalls that “fasciitis can occur in any area of the human body“.
Warning signs to never ignore
The first signs of this infection can be deceptive. “Initial symptoms often resemble those of mastitis: redness, pain and fever. But, in necrotizing fasciitis, the pain becomes very intense, disproportionate to what the skin shows, and the general condition deteriorates quickly.“.
Dr. Kierzek then describes the signs to look out for: “There may be tense edema, blisters, purplish or black discoloration of the skin, and sometimes a foul-smelling discharge — signs of an absolute emergency“.
These symptoms require immediate medical attention, because every hour counts.
Mild infection or life-threatening emergency: how to tell the difference?
According to the emergency doctor, “simple mastitis improves in 24 to 48 hours with rest, milk drainage and, if necessary, an antibiotic“. But he warns:
“If the fever worsens, if the pain or redness spreads quickly or if changes in skin color appear, you should consult urgently.“.
Necrotizing fasciitisrequires hospitalization, strong intravenous antibiotics, and often surgery to excise necrotic tissue“. A medical consultation is therefore essential to make the correct diagnosis and avoid complications.
How to prevent breast infections after childbirth
To avoid such situations, Dr. Kierzek advises increased vigilance:
- Monitor the appearance of nipple cracks and treat them early;
- Vary breastfeeding positions to drain the breast well;
- Avoid tight clothing and maintain rigorous hygiene;
- Consult promptly in case of unusual pain, fever or persistent redness.
And to conclude: “In breastfeeding women, a seemingly trivial breast infection always deserves special attention: it is better to consult early than risk a severe complication!”