Breast Abscess/Mastitis Flashcards
1
Q
ESSENCE
A
Collection of pus within an area of the breast
2
Q
Two types of breast abscess
A
- Lactational abscess
- Non-lactational abscess (unrelated to breast feeding)
3
Q
AETIOLOGY
Causative organisms
A
- Staph aureus
- Most common
- Streptococcal species
- Enterococcal species
- Anaerobic bacteria
- Such as bacteroides and anaerobic streptococci
4
Q
CLINICAL FEATURES
Presentation of mastitis
A
- Acute breast changes
- Nipple changes
- Nipple discharge
- Localised pain
- Tenderness
- Warmth
- Erythema
- Hardening of skin
- Swellihng
- Generalised symptoms of infection
- Muscle aches
- Fatigue
- Fever
- Signs of sepsis
5
Q
CLINICAL FEATURES
Key features to suggest breast abscess
A
Swollen, fluctuan, tender lump within breast
6
Q
INVESTIGATIONS
First investigations for breast abscess
A
- Diagnosis is usually clinical
- Maybe
- Breast US
- Diagnostic needle aspiration drainage
- Cytology of nipple discharge
- Histopathological examination of breast tissue (if concerned about cancer)
7
Q
MANAGEMENT
Lactational mastitis
A
- Conservatively
- Continued breast feeding, breast massage, heat packs, warm showers
- Simple analgesia
- Antibiotics
- If suspected infection
- Flucloxacillin, or erythromycin/clarithromycin in penicillin allergy
8
Q
MANAGEMENT
Non-lactational mastitis
A
- Analgesia
- Antibiotics
- Treatment for underlying cause (such as eczema or candidal infection)
9
Q
MANAGEMENT
Antibiotics for non-lactational mastitis
A
- Co-amoxiclav
- Erythromycin/clarithromycin (macrolides) plus metronidazole
10
Q
MANAGEMENT
Breast abscess
A
- Referall to on call surgical team
- Antibiotics
- Ultrasound (confirm diagnosis and exclude other pathology)
- Drainage (needle aspiration) or surgical incision
- Microscopy, culture and sensitivities of drained fluid
