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General Medicine

Mastitis

Montiel T. Rosenthal, MD and Melissa Christina Saab, MD, BS, BA Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Mastitis is an inflammation of the breast parenchyma and possibly associated tissues (areola, nipple, subcutaneous [SC] fat).

  • Usually associated with bacterial infection (and milk sta...

DIAGNOSIS

  • Fever >38.5°C and malaise

  • Nausea ± vomiting

  • Localized breast tenderness, heat, swelling, and redness

  • Possible breast mass

HISTORY

  • Breast pain

  • “Hot cords burning in chest wall”

  • Consider yeast inf...

TREATMENT

A Cochrane review found that insufficient evidence exists to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis (3)[A]. If present <24 hou...

ONGOING CARE

DIET

  • Encourage oral fluids.

  • Multivitamin, including vitamin A

PATIENT EDUCATION

  • Encourage oral fluids.

  • Rest is essential.

  • Regular emptying of both breasts with breastfeeding

  • Nipple care to preve...

REFERENCES

1
Qiao Y, Hayward JH, Balassanian R, et al. Tuberculosis mastitis presenting as bilateral breast masses. Clin Imaging.  2018;52:28–31.
2
Sam KQ, Severs FJ, Ebuoma LO, et al. Granulomatous...

ADDITIONAL READING

  • Amir LH, Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #4: mastitis, revised March 2014. Breastfeed Med.  2014;9(5):239–243.

  • Crepinsek MA, Crowe L,...

CODES

ICD10

  • N61 Inflammatory disorders of breast

  • O91.22 Nonpurulent mastitis associated with the puerperium

  • O91.23 Nonpurulent mastitis associated with lactation

  • N60.19 Diffuse cystic mastopathy of unspec...

CLINICAL PEARLS

  • Complete emptying of the breasts on a regular schedule, avoiding constrictive clothing or bras that might obstruct breast ducts. Meticulous attention to nipple care, “adequate rest,” a...

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Mastitis. A: This infant has mastitis. The breast is swollen and erythematous, with some areas suggesting abscess formation. B: In contrast, this newborn has physiologic gynecomastia and lactation (“witch's milk”). Note that the breast shows no erythema.From Fleisher GR, MD, Ludwig W, MD, Baskin MN, MD. Atlas of Pediatric Emergency Medicine. Philadelphia: Lippincott Williams & Wilkins, 2004.
Mastitis. A: This infant has mastitis. The breast is swollen and erythematous, with some areas suggesting abscess formation. B: In contrast...
Mastitis.
Mastitis.
FIG. 11.43. Mastitis. A: This infant has mastitis. The breast is swollen and erythematous, with some areas suggesting abscess formation. B: In contrast, this newborn has physiologic gynecomastia and lactation ("witch's milk"). Note that the breast shows no erythema.
FIG. 11.43. Mastitis. A: This infant has mastitis. The breast is swollen and erythematous, with some areas suggesting abscess formation. B:...
Breast Infection and Inflammation Labeled
Breast Infection and Inflammation Labeled
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