Mastitis

Describes inflammation of the breast tissue, both acute or chronic

Aetiology

Can be classed by lactation status:
  • Lactational mastitis (more common) is seen in up to a third of breastfeeding women; it usually presents during the first 3 months of breastfeeding or during weaning
    • Causative organisms: staph aureus, strep pyrogenes
  • Non-lactational mastitis (less common) can also occur, especially in women with other conditions such as duct ectasia, as a peri-ductal mastitis
    • Tobacco smoking is an important risk factor, causing damage to the sub-areolar duct walls and predisposing to bacterial infection
    • Causative organisms: mixed organisms, anaerobes

Clinical presentation

  • Induration
  • Tenderness
  • Swelling
  • Eythema
  • Fever

Investigations

  • Clinical diagnosis

Management

  • Flucloxacillin 500 mg orally every 6 hours or augmentin 625 mg every 8 hours for 7 days
  • Patient should be examined every 3 days to be certain the infection is responding to therapy and that there is no evidence of abscess formation
  • In lactational mastitis, continued milk drainage or feeding is recommended

Complications

  • Breast abscess