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Case 72 - A 20-Year-Old with Right Breast Pain and Fever while Breast-Feeding

from Section 7 - Postpartum

Published online by Cambridge University Press:  08 April 2025

Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

This case reviews the presentation, diagnosis, and treatment of lactation mastitis. New clinical evidence suggests that lactation mastitis is a spectrum of disorders due to underlying inflammation and edema of the mammary gland. Persistent untreated inflammation can lead to bacterial mastitis, galactocele, phlegmon, or abscess formation. A focused history and physical examination are necessary to identify the specific cause of symptoms and target therapy. Current evidence shows that early identification of mastitis and timely treatment of underlying inflammation can help reduce unnecessary antibiotic use and prevent progression to more severe disease.

Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
, pp. 221 - 223
Publisher: Cambridge University Press
Print publication year: 2025

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References

World Health Organization. Mastitis: Causes and Management. Geneva: World Health Organization; 2000. https://apps.who.int/iris/handle/10665/66230 (accessed April 22, 2023).Google Scholar
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Lawrence, RA, Lawrence, RM. Breastfeeding: A Guide for the Medical Professional, 9th ed. New York: Elsevier; 2021.Google Scholar
Weaver, SR, Hernandez, LL. Autocrine-Paracrine Regulation of the Mammary Gland. J Dairy Sci. 2016;99:842853.CrossRefGoogle ScholarPubMed
Mitchell, KB, Johnson, HM, Rodriguez, JM, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeeding Med. 2022;17(5):360–376.CrossRefGoogle Scholar
Jahanfar, S, Ng, CJ, Teng, CL. Antibiotics for Mastitis in Breastfeeding Women. Cochrane Database Syst Rev. 2013;(2):CD005458.CrossRefGoogle Scholar
Amir, LH, Forster, D, McLachlan, H, et al. Incidence of Breast Abscess in Lactating Women: Report from an Australian Cohort. Br J Obstet Gynaecol. 2004;111:13781381.Google ScholarPubMed
Johnson, HM, Mitchell, KB. Low Incidence of Milk Fistula with Continued Breastfeeding Following Radiologic and Surgical Interventions on the Lactating Breast. Breast Dis. 2021;40:183189.CrossRefGoogle ScholarPubMed
Dagla, M, Dagla, C, Mrvoljak-Theodoropoulou, I, et al. Do Maternal Stress and Depressive Symptoms in Perinatal Period Predict the Lactation Mastitis Occurrence? A Retrospective Longitudinal Study in Greek Women. Diagnostics (Basel). 2021;11:1524.CrossRefGoogle ScholarPubMed

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