Acute Mastitis

Acute Mastitis

• Due to
•  lactational mastitis.
• Infection of a hematoma
• Non-lactational breast abcesses – in pt with duct ectasia and periductal mastitis
• common complaint in nursing women. 
• Develops when bacteria gain access to the breast tissue through the ducts:
• Through fissures in the nipples
• Various forms of dermatitis involving the nipple
• Inspissations of secretions, causing blockage of the duct system

Organism responsible is always Staph aureus

—  During the cellulitic stage of mastitis, the pt should be treated with antibiotics: flucloxacillin or co-amoxiclav ( amoxicillin + clavulanic acid )

—  If started too late, tissue damage and accumulating polymorphs cause multiple loculi of pus to form à treated by surgical drainage

—  The breast should be incised & drained if the infection did not resolve within 48 hours or if after being emptied of milk, there was an area of tense induration or other evidence of underlying abscess

—  Clinical features:

—  Severe breast pain

—  Swollen, tense, tender and warm to touch (sx of cellulitis stage)

—  Once abcess develops, there is high grade fever with chills and rigors