6. Inflammatory conditions of female breast and duct ectasia Flashcards
Inflammatory Conditions of the Breast
Acute Inflammatory Conditions of the Breast
Chronic Inflammatory Conditions of the Breast
Acute Inflammatory Conditions of the Breast
- Acute lactational mastitis
* Breast abscess
Chronic Inflammatory Conditions of the Breast
- Chronic pyogenic breast abscess
* Mammary duct ectasia
Acute lactational mastitis
- Etiology
- Route of infection
- Predisposing factors
- Clinical picture
- Treatment
Etiology of Acute lactational mastitis
Infection is caused by coagulase positive staphylococcus aureus
Less common by Streptococcus hemolyticus
Significance of coagulase positive staphylococcus aureus in Etiology of Acute lactational mastitis
The organism is claimed to induce clotting of milk in the ducts, producing obstruction and stasis
Route of infection in Acute lactational mastitis
Organisms from the mouth of the suckling infant gain access through:
- nipple cracks
- openings of the lactiferous ducts.
Predisposing factors ofAcute lactational mastitis
- Milk engorgement
- Abrasions to the nipples
- Poor hygiene.
Pathogenesis of Milk engorgement in Predisposing factors ofAcute lactational mastitis
Caused by:
- Inspissated milk
- Epithelial debris that block the ducts.
Pathogenesis of Abrasions to the nipples in Predisposing factors ofAcute lactational mastitis
Caused by suckling
Clinical picture of acute lactational mastitis
- Stage of milk engorgement صدري مزند
- stage of acute mastitis
- stage of acute abscess
- stage of chronic abscess
Stage of milk engorgement in Clinical picture of acute lactational mastitis
- Breast involvement
- C/O
- O/E
Breast involvement in Stage of milk engorgement in Clinical picture of acute lactational mastitis
This may affect the whole or a sector of the breast
C/O in Stage of milk engorgement in Clinical picture of acute lactational mastitis
- Dull aching pain in the breast
* mild pyrexia.
O/E in Stage of milk engorgement in Clinical picture of acute lactational mastitis
- Enlargement and induration of the breast
* but there are no physical signs of inflammation.
Stage of acute mastitis in Clinical picture of acute lactational mastitis
- C/O
* O/E
C/O in Stage of acute mastitis in Clinical picture of acute lactational mastitis
- The pain gets worse
* There is continuous higher pyrexia
O/E in Stage of acute mastitis in Clinical picture of acute lactational mastitis
- Breast:
* Axillary L.N
Breast O/E in Stage of acute mastitis in Clinical picture of acute lactational mastitis
- Diffuse (or localized according to immune response) swelling & induration of the breast.
- Redness, hotness, and tenderness.
Axillary L.N O/E in Stage of acute mastitis in Clinical picture of acute lactational mastitis
Enlarged, firm & tender.
Stage of acute abscess in Acute lactational mastitis
Pain is throbbing.
Temperature is hectic.
Pitting edema is elicited in the area of the skin overlying the abscess.
Do not wait for fluctuation.
Purulent discharge may be present.
The reason why we don’t wait for fluctuation instage of acute abscess in acute lactational mastitis
Fluctuation is late as abscess is deep
Treatment of Acute lactational mastitis
(A) Before the development of an abscess )> medical treatment
(B) Abscess formation )> incision and drainage