Necrotizing fasciitis of the breast: a case managed without mastectomy

OBJECTIVE

To report a rare presentation of necrotizing fasciitis (NF) in the breast and its management.

CLINICAL PRESENTATION AND INTERVENTION

A 61-year-old non-diabetic lady presented with a painful swollen right breast and yellowish discharge associated with fever for the last few days. Based on clinical examination and haematological parameters, a provisional diagnosis of breast abscess was made that later proved to be a case of NF. She was managed conservatively with repeated debridement followed by split-skin grafting with preservation of the breast.

CONCLUSION

This case showed that NF of the breast can present as a simple breast abscess which was managed conservatively.

Granulomatous inflammatory response in a case of typhoid fever

OBJECTIVE

To present a case of culture-proven typhoid fever in which granulomas were demonstrated histologically in the ileum and mesenteric lymph nodes.

CLINICAL PRESENTATION AND INTERVENTION

A 47-year-old Pakistani man underwent emergency hemicolectomy for severe bleeding per rectum associated with diarrhea. Two large ulcers in the ileum, near the ileocolic junction, as well as mesenteric lymph nodes showed both necrotizing and non-necrotizing granulomas in addition to mixed inflammatory infiltrate on histology.

CONCLUSION

Typhoid fever may be considered as one of the causes of the differential diagnoses of granulomatous inflammation of the small intestine.