Mastitis

mastitis

1. MASTITISMASTITIS
VIDULA SHEVADEVIDULA SHEVADE
603603

2. MastitisMastitis
An acute inflammation of the An acute inflammation of the
interlobular connective tissue within interlobular connective tissue within
the mammary glandthe mammary gland

3. ANATOMY OF BREASTANATOMY OF BREAST
•Breast are modified sweat glands lying on
pectoralis fasia and musclature of chest
wall.
•It is surrounded by skin and subcutaneous
fat.
•Transversely it extends from the side of
sternum to near mid-axillary line.

4. ANATOMY OF BREAST ANATOMY OF BREAST
•Vertically it extends from 2
nd
to 6
th
rib.

5. Predisposing factors of mastitisPredisposing factors of mastitis
•Damaged nipple (nipple fissure)
•Primiparity
•Previous history of mastitis
•Maternal or neonatal illness
•Maternal stress
•Work outside the home
•Trauma
•Genetic

6. Classification Classification
•Etiology
•Infectious
•Non-infectious
•Milk stasis
•Abcess formation

7. INFECTIOUSINFECTIOUS
•Most comman pathogen is staphylococcus
aureus
•Sometimes streptococcus is also detected

8. NON INFECTIOUS CAUSES NON INFECTIOUS CAUSES
•It includes carcinomatous processes
which causes,
•Hyperplasia of cells.
•Leading to duct obstruction.

9. BREAST ABSCESSBREAST ABSCESS
•A breast abscess is a collection of pus
that develops into the breast.

10. BREAST ABSCESSBREAST ABSCESS
•Most common in first 6 weeks
•5-11% of mastitis cases
•Affect future lactation in 10% of affected ♀
•No differences b/t groups by age, parity,
localization of infection, cracked nipples, +
milk cultures.
•Duration of symptoms: only independent
variable favoring abscess development

11. MILK STASISMILK STASIS
–Stagnant milk increases pressure in
breast leading to leakage in surrounding
breast tissue
–Milk, itself, causes an inflammatory
response
•+/- Infection
–Milk provides medium for bacterial
growth

12. ClassificationClassification
•Types
•Puerperal mastitis
•Non puerperal mastitis

13. Puerperal mastitisPuerperal mastitis
•Puerperal mastitis is the inflammation of
the breast in connection with pregnancy
and breastfeeding.
• it is caused by blocked milk ducts.

14. Nonpuerperal mastitisNonpuerperal mastitis
•The term nonpuerperal mastitis describes
inflammatory lesions of the breast
occurring unrelated to pregnancy and
breastfeeding.

15. CLINICAL FEATURESCLINICAL FEATURES
•Breast tenderness or warmth to the touch
•General malaise or feeling ill
•Swelling of the breast
•Pain or a burning sensation continuously
or while breast-feeding
•

16. CLINICAL FEATURESCLINICAL FEATURES
•Skin redness, often in a wedge-shaped
pattern
•Fever of 101 F (38.3 C) or greater
•The affected breast can then start to
appear lumpy and red.

17. STAGESSTAGES
Cellulitic stages
In which breast as a whole becomes red
and extermely painful.
Abscess
When the abscess develops redness
becomes limited to area of abscess
formation.

18. STAGESSTAGES
•Edema ,tenderness,brawny induration are
the three main features of abscess
formation.

19. TEST AND DIAGNOSISTEST AND DIAGNOSIS
•The diagnosis of mastitis and breast
abscess can usually be made based on
a physical examination.
• ultrasound.
• a clear image of the breast tissue and
may be helpful in distinguishing between
simple mastitis and abscess

20. TEST AND DIAGNOSISTEST AND DIAGNOSIS
• In cases of infectious mastitis, cultures
may be needed in order to determine what
type of organism is causing the infection.
•Staph Aureus
Group A and B βhemolytic Strep, E Coli,
H. flu
•MRSA
•Fungal infections
•TB where endemic – 1% of cases

21. TEST AND DIAGNOSISTEST AND DIAGNOSIS
•Mammograms or breast biopsies are
normally performed on women who do not
respond to treatment or on non-
breastfeeding women.

22. MAMMOGRAMMAMMOGRAM

23. Differential DiagnosisDifferential Diagnosis
•Galactocele: smooth rounded swelling
(cyst)
Inflammatory Breast Carcinoma: unilateral,
diffuse and recurrent, erythema,
induration.
Enlargement of regional lymph nodes.

24. ComplicationsComplications

25. Breast AbscessBreast Abscess

26. Other ComplicationsOther Complications
•Distortion of breast
•Chronic inflammation

27. TREATMENTTREATMENT
•Supportive Therapy
–Rest, fluids, pain medication, anti-
inflammatory agents,
• lactation mastitis
• -frequent emptying of both breasts by
breastfeeding is essential. Also essential
is adequate fluid supply for the
mother and infant

28. TREATMENTTREATMENT
•For breastfeeding women with light
mastitis, massage and application of heat
prior to feeding can help as this may aid
unblocking the ducts. However in more
severe cases of mastitis heat or massage
could make the symptoms worse and cold
compresses are better suited to contain
the inflammation

29. TREATMENTTREATMENT
•INFECTIOUS MASTITIS
• Dicloxacillin or cephalexin are
recommended, because of the high rates
of penicillin resistant staphylococci.
•Minimum treatment 10-14 days.

30. TREATMENTTREATMENT
•An abscess (or suspected abscess) in the
breast may be treated by ultrasound-
guided fine-needle
aspiration (percutaneous aspiration) or by
surgical incision and drainage; each of
these approaches is performed under
antibiotic coverage. In case of puerperal
breast abscess, breastfeeding from the
affected breast should be continued where
possible.