Lactation mastitis may develop in a woman in the postpartum period, especially if she is breastfeeding. It needs to be distinguished from a breast engorged with milk.
|
Feature |
Engorgement |
Mastitis |
Abscess |
|
laterality |
bilateral |
usually unilateral |
unilateral |
|
breast pain |
present |
present |
present |
|
fever (> 38°C), chills |
absent |
present |
present |
|
erythema, warmth, edema and/or tenderness |
absent |
present |
present |
|
mass (hard or fluctuant) |
absent |
absent |
present |
|
milk WBC count |
< 10^6 per mL |
>= 10^6 per mL (>= 1,000 per µL) |
variable |
Risk factors:
(1) previous history of lactation mastitis (previous or current postpartum period)
(2) presence of milk stasis with inadequate drainage
(3) presence of nipple fissures, cracks or sores
Some cases of mastitis may be noninfectious.
Infectious mastitis may be separated into those with and without pathogenic bacteria. Getting an accurate culture is difficult with contamination with skin flora common.
Bacteria isolates may include:
(1) Staphylococcus aureus
(2) Streptococcus, especially beta hemolytic (Group A)
(3) Enterococcus species
(4) coagulase negative Staphylococcus or other skin flora
(5) Hemophilus species
(6) enterobacteria (E. coli, other)
Specialty: Obstetrics & Gynecology
ICD-10: ,
