Mastitis/Breast Abscess

Question 1

What are the causes mastitis/breast abscesses?

Answer 1

• Staphylococcus aureus = most common pathogen
• 1 in 10 due to milk duct backup
• Nipple injury
• Smoking

Question 2

What are the signs and symptoms of mastitis/breast abscesses?

Answer 2

• Coryzal symptoms – aches, chills, fever
• Nipple discharge
• Red, tender breast with possible abscess

Question 3

What are the appropriate investigations for suspected mastitis/breast abscess?

Answer 3

Clinical diagnosis

• USS for abscess diagnosis
• Could do MRI/mammogram to rule out more sinister diagnose

Question 4

What is the management of mastitis?

Answer 4

• Non-severe or lactational
  
  • Simple analgesia
  • Supportive care
  • Continue breastfeeding
• Non-lactational or severe = infected nipple fissure, S/S not improved after 12-24hrs, breast milk culture +ve
  
  • 1st line = flucloxacillin
  • 2nd line = co-amoxiclav
  • MRSA = trimethoprim

Question 5

What is the management of a breast abscess?

Answer 5

Incision and drainage and culture of fluid

Question 6

What are the complications of mastitis/breast abscess?

Answer 6

• Sepsis
• Scarring
• Functional mastectomy
• Breast hyperplasia
• Prognosis = most have resolution of mastitis after 2-3 days of antibiotic therapy