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Flashcards in Mastitis Deck (14)
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1

def

inflammation of breast with or without infection

2

what are the different types of mastitis

1 with infection
-lactational (peurperal)
2 without infection
-non-lactational (duct ectasia)
-idiopathic granulomatous inflammation

3

aetiology

1 with infection
-bacteria colonizing the skin
2 without infection
-duct ectasia
-foreign material (nipple piercing, breast implant)

4

what bacteria commonly cause infectious mastitis

1 s. aureus
2 coagulase negative staphylococci

5

what is duct ectasia

lactiferous ducts become blocked or clogged
causes greenish discharge

6

epi

1-10% of lactating women worldwide
duct ectasia in 5-9% of non-lactating women

7

history + examination

1 flu like symptoms
-malaise
-myalgia
-fever
2 breast warmth, swelling, tenderness, redness
3 decreased milk outflow

8

risk factors

1 female
2 15-45yrs
3 lactation + milk stasis

9

investigations

1 clinical examination
2 breast USS
-hypoechoiec lesion indicates abscess
3 aspiration
-purulent fluid indicates abscess
4 milk, aspirate, discharge or biopsy tissue can be used for culture and sensitivity
-identify infection

10

management of lactational mastitis

if mild mastitis: conservative treatment which includes effective milk removal (frequent breastfeeding or breast pumping)
if severe mastitis: medical and conservative treatment with flucloxacillin (oral-anti-staphylococcal penicillin) and effective milk removal

11

management of non-lactational mastitis

1st line treatment: flucloxacillin (oral anti-staphylococcal penicillin) + fluconazole (antifungal therapy)
2nd line treatment: if MRSA indicated then give vancomycin + fluconazole

12

complications

cessation of breast feeding
breast abscess (complicating mastitis)

13

prognosis

if treated promptly and appropriately, most breast infections will resolve

14

when should nursing mothers with a breast infection not breastfeed

if they are HIV infected
if they are being treated with trimethoprim or sulfamethoxazole