mastitis
MASTITIS
Mastitis is the inflammation of the breast that may or may not be associated with bacterial infection.
Staphylococcus aureus is the most common organism associated with mastitis.
It may occur spontaneously or during lactation. It most frequently occurs during the first 6-8 weeks postpartum, although it may occur any time during breastfeeding.
Nonpuerperal mastitis is most commonly associated with breast cyst.
Breast abscess (collection of pus in the breast) is a complication of mastitis.

Diagnosis

  • Diagnosis is based on clinical evaluation
    • Severe breast engorgement in a lactating woman can be differentiated from mastitis by its bilateral engorgement with generalized involvement

Laboratory Tests

  • Laboratory tests may be indicated in cases of severe or recurrent mastitis, hospital-acquired mastitis, inadequate response to first-line antibiotics within 2 days, allergy to usual therapeutic antimicrobials, or when hospital admission is warranted
    • May include breastmilk culture and sensitivity (hand-expressed, midstream, clean-catch sample), complete blood count (CBC), C-reactive protein (CRP)
  • Diabetes and HIV testing may be indicated if yeast is found in nonpuerperal mastitis

Imaging

  • Ultrasound may be done if breast abscess is suspected
    • Drainage of abscess may be done under ultrasound guidance
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