Cuando el neumococo no afecta el pulmón: Reporte de caso de una mastitis necrotizante por Streptococcus pneumoniae
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La mastitis necrotizante es una complicación poco común en mujeres lactantes, con potencial de causar daño severo. Streptococcus pneumoniae, habitualmente asociado a infecciones respiratorias y meningitis, rara vez se identifica en infecciones mamarias. Se describe el caso de una mujer de 28 años, inmunocompetente, que desarrolló una mastitis de evolución rápida hacia fascitis necrotizante con compromiso extenso, inestabilidad hemodinámica y requerimiento de múltiples intervenciones quirúrgicas, tratamiento antibiótico de amplio espectro y reconstrucción mamaria. El cultivo confirmó Streptococcus pneumoniae como agente etiológico. Se realizó una revisión sistemática en nueve bases de datos, que permitió identificar 10 casos previos en mujeres lactantes sanas, todos con evolución más favorable y sin necesidad de cirugía mayor. Este caso constituye el primero documentado en América Latina con este nivel de afectación. Ante presentaciones mamarias inusuales y evolución acelerada, es importante considerar microorganismos menos frecuentes y actuar con rapidez para evitar complicaciones graves
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