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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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