(B)- Breast Abscess Flashcards
What is a breast abscess?
Collection of pus caused by bacterial infection
What are the types of breast abscess?
Lactational and non-lactational abscesses
What is pus caused by?
Produced by inflammation, contains dead WBCs and waste from infection
How does an abscess form?
Pus gets trapped in specific area and cannot drain
What happens in lactational mastitis?
Bacteria enter nipple and back-track to ducts from baby’s mouth causing infection
Can lead to development of an abscess
What is a key risk factor for breast abscess development?
- Smoking
- Nipple damage (e.g. piercings, eczema)
- Underlying breast disease
What are the most common causative bacteria for breast abscesses?
Staphylococcus aureus
Streptococcal species
Enterococcal species
Anaerobic bacteria
How do breast abscesses present?
- Acutely
- Nipple change
- Purulent nipple discharge
- Pain and tenderness
- Warmth and erythema
- Hardening
- Swelling
- May have generalised infection symptoms
How is lactational and non-lactational mastitis managed?
Lactational mastitis
- Conservatively with continued breastfeeding, expressing milk and breast massage
- Flucloxacillin
- Erythromycin if penicillin allergy
Non-lactational mastitis
- Analgesia
- Antibiotics
- Treat underlying cause (e.g. eczema or candida infection)
What antibiotics are used in non-lactational mastitis?
Must be broad-spectrum
Co-amoxiclav
or
Erythromycin + Metronidazole (for anaerobes)
How are breast abscesses managed?
- Referral to on-call surgical team
- Antibiotics
- USS
- Drainage
- Microscopy, culture and sensitives
How are breast abscesses managed in breastfeeding women?
Continue breastfeeding
Regularly express milk if feeding is too painful, resume feeding when possible
Not harmful to baby
