,mlhjBreast infections

Lactational breast abscess

Usually due to Staph. aureus Usually peripherally situated Surgery may be pre-empted by early diagnosis Attempt aspiration If no pus - antibiotics If pus present consider repeated aspiration or incision and drainage Consider biopsy of cavity wall Continue breast feeding from opposite breast No need to suppress lactation

Non-lactational breast abscess

Occur in periareolar tissue Culture yield - Bacteroides anaerobic strep enterococci Usually manifestation of duct ectasia ! periductal mastitis Occur "#- $# years %ore common in smo&ers Often give history of recurrent breast sepsis 'epeated aspiration is the treatment of choice %etronida(ole and fluclo)acillin *rain through small incision if non-resolving *efinitive treatment when +uiescent with antibiotic prophyla)is Usually a ma,or duct e)cision - Adair.s operation Spontaneous discharge or surgical e)cision can result in mammary fistula

Bibliography
*i)on / %0 Breast Infection0 BMJ 12234 "#25 23$-2320 %archant * /0 Inflammation of the breast0 Obstet Gynecol Clin North Am 6##64 625 72-1#60 Scott-Connor C 80 Schorr S /0 9he diagnosis and management of breast problems during pregnancy and lactation0 Am J Surg 122:4 1;#5 3#1-3#:0