A rare case of necrotic erysipelas of the breast in a healthy, postpartum female

Breast erysipelas is extremely rare, particularly cases with necrosis or requiring surgical intervention. Scant evidence exists, with most occurring in otherwise immunocompromised or comorbid patients. This is a case of severe erysipelas in an otherwise healthy, postpartum female. She presented initially with mastitis appearing changes, with gradual progression to necrosis. Importantly, another uncommon, but more lethal, diagnosis was considered and excluded: necrotizing fasciitis. Ultimately, this patient required several operations and skin grafting, with good cosmetic outcome. The case highlights the need for early and senior surgical review to exclude more concerning diagnoses, as well as prompt antibiotic treatment and surgical debridement.