A Family Doctor's Tale - MASTITIS

DOC I HAVE A BREAST INFECTION
Mastitis or inflammation of the breasts are commonly seen at puberty or in breast feeding mothers.
Engorged breasts during breast feeding are quite common and be treated easily with antibiotics and proper expression of milk. The mastitis of puberty are usually transient and most adolescents will adjust to the enlargement of the breasts.

Mastitis is inflammation or infection of the breasts, resulting in pain and swelling.


The causes of Mastitis are mostly due:

A.Hormonal:

1.In babies whether male or female, the painless swelling of the breast may occur due to the effects of the mother's female hormones.The swelling usually subsides after a few weeks.


2.At Puberty for girls the development of breasts may cause some pain and swelling. 
It may occur first on one side and then subsequently on the side.
The nipples may be red and tender and this may cause worry for the adolescent girl and her mother.


3.Premenstrual pain and swelling of breasts may occur


B.Infections:

Infections of the breasts may occur due to
1.poor skin hygiene


2.Injuries or wounds allowing micro-organism to enter the wound


3.Breastfeeding as a result of the baby sucking the nipple incorrectly or as a result of blockage of the milk ducts. 
In either case bacteria can enter through the injured nipple or the inflammation of the blocked milk ducts may cause suppuration and abscess formation.


4.Mastitis may occur as a rare complication of mumps.


5.Most common bacteria infection is staphyloccus aures.


6.Other rare causes of mastitis are tuberculosis, syphilis or actinomycosis


The Symptoms of Mastitis are:

1.Pain usually present in all cases except in babies


2.swelling of the breasts or the nipple area


3.Pus discharge from the nipple


Signs:

1.redness of the nipple or areola


2.red, warm swelling of the breast tissue may indicate presence of formation of abscess.


3.Local tenderness of inflamed area


4.Fever and general malaise


5.Axillary lymph nodes may be swollen and painful


Complications are:
1.Abscess formation


2.Cystic formation


3.Chronic mastitis or fibroadenosis


Diagnosis is by :
1. clinical features of mastitis


2. Mammograms to exclude malignant tumors


3. Ultrasound scan of the breasts


Treatment is by:
1. antibiotics are given to cure the infections.
The antibiotics may need to be taken for 10 days by mouth.
They must not be stopped just because the discomfort stops, or the infection will NOT be cured.


2. Painkillers may be given if there is pain


3.Rest and support of the breasts with soft bras


4.Warm water bottle to apply to areas of inflammation due to blocked milk to soften the milk and induce flow.


5. surgery with drainage of abscess if antibiotic do not work.
Aspiration of cysts may also be necessary


6.Reassurance in hormonal cases of mastitis


Most cases of mastitis usually will recover with proper treatment.


Practice good personal and skin hygiene
Wash hands frequently
Clean the beasts properly before and after breastfeeding
Patients should be taught to do breast self examination and to do it frequently