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Mastitis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Infection of the breast causing pain, swelling, and erythema

  • Most commonly in women who are breast-feeding

  • Often with systemic symptoms also:

    • Malaise

    • Fever

  • Incidence may be as high as 33%...

Diagnosis

Signs and Symptoms

  • Fever and chills

    • Temperature usually >38.3°C (101°F)

  • General malaise

  • Tachycardia

  • Breast pain, induration, erythema, warmth; usually unilateral

  • Onset typically 2–3 wk to month...

Treatment

Pre-Hospital

Generally no pre-hospital treatment needed 

Initial Stabilization/Therapy

No specific stabilization 

Ed Treatment/Procedures

  • Continue breast-feeding:

    • Child and mother are colonized wi...

Follow-Up

Disposition

Admission Criteria

  • Incision and drainage under general anesthesia may be necessary and require admission

  • Immunocompromised or evidence of septicemia

  • Patients with diabetes may accoun...

Pearls and Pitfalls

  • Most cases respond to lactation and warm compresses without antibiotics

  • Cessation of breast-feeding will lead to increased milk stasis and increased risk for abscess formation

  • One of...

Additional Reading

  • Dixon  JM, Khan  LR. Treatment of breast infection. BMJ.  2011;342:d396.

  • Jahanfar  S, Ng  CJ, Teng  CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst R...

Codes

ICD9

  • 611.0 Inflammatory disease of breast

  • 675.24 Nonpurulent mastitis associated with childbirth, postpartum condition or complication

  • 778.7 Breast engorgement in newborn

  • 675.14 Abscess of breast as...

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