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Background: Non Nursing Breast Abscess is formation of pus in Breast resulting from an infection in not pregnant or breastfeeding women. Incidence of such Abscess in non nursing women is although less but rising. These are either in nipple areolar region or peripheral in breast..Aim of this study is to explore the cause of Abscess,Early diagnosis, identification of organisms & sensitivity to antibiotics & to assess treatment modality. Observational StudyMethods: Results: Breast Abscess In 30 non nursing Patients of age group 28-55 yrs,developed due to Diabetes in 18 (60%), Mastitis in 6 (20%),Trauma in 3 (10%),Duct ectasia 1 (3.3%),Cacinoma 2 (6.6%) .Most frequent organism seen was Staphylococcus Aureus,but Streptococcus & Pseudomonas also isolated.Early Diagnosis was possible by Ultrasound. Incision & Drainge under Anaesthesia in 20 (66.6%) with antibiotics & treating underlying disease.Antibiotics with Percutaneous Aspiration in 5 (16.6%) and only Antibiotics in 3 (10%) Patients required. Breast Abscess inConclusions: Non Nursing Women is infrequent entity in comparison to that in Nursing Women,Early Diagnosis is possible by Ultrasound examination.Incision & drainage mostly required but Percutaneous Aspiration is also helpful.02 Patients (6.6%).with cancer didnot improve.
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Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.
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Granulomatous mastitis is a chronic inflammatory condition of the breast that is rarely described in literature. It mimics breast abscess on clinical presentation giving dilemma to the surgeon. The etiology can be infectious, autoimmune or idiopathic. The various modalities of treatment for idiopathic granulomatous mastitis includes drainage of abscess, antibiotics and corticosteroid therapy. This is a case series of ten cases of diagnosed with granulomatous mastitis treated in the period of 2 years from 2018 and 2019 in Department of General Surgery, MGM Hospital Navi Mumbai. The data of all the patients were collected from records. They were following at regular intervals in the outpatient department to assess recurrence. The mean age of the patients was 41 years (range 26–47 years). Six patients gave history of breast-feeding in the last 5 years, one was lactating at the time of presentation. One of the patients was treated empirically for Tuberculous mastitis for the opposite breast. Others had no history suggestive of tuberculosis or other connective tissue diseases, such as rheumatoid arthritis or sarcoidosis USG breast was performed in all cases. Hypoechoic abscess was seen in 5 cases. The time taken for complete resolution of the disease was ranging from 2 weeks to 2 months. All patients had an uneventful recovery and no recurrences reported till now. GM is a rare benign breast disease that is difficult to distinguish from other inflammatory breast diseases or cancer. The diagnosis of GM must be based on a multidisciplinary approach. Surgical management followed by antibiotics was found to be sufficient to treat the condition in our patients. Corticosteroids need not be administered in all cases of this benign breast disease.
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Background: Neonatal mastitis may occur de novo due to infection by various organisms, most notably Staphylococcus aureus. This condition usually responds well to treatment, but may sometimes progress to breast abscess formation.Methods: This was a retrospective study. All the patients who were admitted in hospital with admission diagnosis of neonatal mastitis or breast abscess were included in this study. Various demographic, clinical and lab data were recorded and analyzed.Results: Total 11 patients fulfilled the inclusion criteria and were included in the study. (7 females: 4 males). Swollen and red breast area was the most common presenting complaint, seen in 10 patients. One patient came with complaint of pus draining from the swollen breast. 2 patients were febrile. The age at presentation varied from 7 days to 30 days (median age 14 days). 7 patients had undergone breast massage at hands of their family members to express the witch's milk. Pus culture from the 6 cases of breast abscesses grew Staphylococcus aureus in 3 cases and Coagulase negative staph (CONS) in 1 patient. Blood culture was sterile in 8 cases, grew CONS in two cases and MRSA in 1 patient. In all the cases where blood culture grew an organism, a lumbar puncture was also done but CSF analysis was normal in all the cases. Drainage of abscess and IV antibiotics led to resolution of disease in all patients and none of the patients developed any complications.Conclusions: Neonatal mastitis and breast abscess is not an uncommon condition. Complications are very rare and the condition responds well to IV antibiotics. People should be made aware about the ill effects of cultural practice of breast massage to express witch's milk in neonates. Early treatment of mastitis leads to better outcome and lesser chances of abscess formation.
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Breast abscess in pregnancy due to Salmonella has been very rarely reported in the literature and most of the cases till now are due to unknown risk factors or in otherwise immunocompromised adults. Localized disease can occur due to bacteremia followed by seeding of bacteria at distant sites. We report two cases of breast abscess in pregnancy cause by Salmonella typhi where drainage of abscess and appropriate antibiotics helped in complete resolution.
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Objective To evaluate clinical efficacy and safety of single puncture and irrigation with Mammotome system in treatment of lactational breast abscess without drainage. Methods 32 patients with lacta-tional breast abscess were treated with ultrasound-guided puncture and irrigation by Mammotome system. Pus was cleared and necrotic material was removed. The residual cavity was irrigated with 3% hydrogen peroxide solution and Kangfuxin solution and no drainage was placed. Breast-feeding on time was encouraged. Results All pa-tients were successfully treated with single puncture and irrigation. The average length of hospital stay was 4 days. Except for 3 cases actively requesting to stop lactating, the other 29 patients continued to breast-feed. There was one case with postoperative hematoma, one with wound granuloma, and no other complications occurred. There was no relapse during the follow-up of 3 to 36 months. All patients were satisfied with the appearance of the breasts. Conclusions Single puncture and irrigation with Mammotome system without drain placement is a safe procedure in treatment of lactational breast abscess with the advantage of minimal invasion, low complication and does not affect breastfeeding.
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Tuberculosis is an endemic and very common disease in India. Breast tuberculosis is often confused with breast malignancy or pyogenic abscess. We report a rare case of breast tuberculosis which is successfully managed with Anti-tubercular drugs. After six months of compliant treatment patient delivered a healthy baby.
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Although some full-term neonates suffer from mastitis or a breast abscess, mastitis is not common in neonates and concurrent bacteremia is a rarely seen. We report the case of a 30-day old boy of African ethnicity, who was a full-term infant and appropriate for gestational age. At birth, he had bilateral palpable breast masses. He had high fever as well as swelling and nipple discharge in both breasts 30 days after birth. An ultrasonography of the breast showed masses with septa in both breasts. The breast masses were red in color, swollen, and felt hot to the touch. We incised the mass and performed a culture of the discharge. Staphylococcus epidermidis was detected in both blood and the breast discharge. In conclusion, the infant experienced neonatal bacteremia that originated from a breast abscess.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Abscess , Bacteremia , Breast , Fever , Gestational Age , Mastitis , Nipples , Parturition , Sepsis , Staphylococcus epidermidis , UltrasonographyABSTRACT
Bacterial mastitis is the most common variety of mastitis and is often caused by Staphylococcus aureus. Chronic mastitis is usually seen as a complication of tuberculosis & syphilis. A 31-year-old female presented with lump in the right breast for the past two years with pain for the past 15 days and discharge for the past two to three days. On examination, the lump was measured and was approximately 4x4 cm in size with a discharging sinus just lateral to the areola. No regional lymphadenopathy was noticed. A clinical diagnosis of “Lump in the right breast” with sinus probably due to tuberculosis was made. The lump had been excised surgically. Salmonella paratyphi A was isolated after repeated culture. She had responded to ceftriaxone, hence, unnecessary use of anti-tubercular drugs could be avoided. In chronic mastitis and breast abscess Salmonella species should be considered as one of the etiological agents.
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, less morbidity and will allow the patient to carry on breast feeding. Aims & Objective: The aim of this study is to compare the management of puerperal breast abscess by percutaneous ultrasound guided needle aspiration versus open surgical drainage with special attention to resolution and complications. Material and Methods: In this interventional study, 70 puerperal breast abscess cases were randomly divided and undergone either percutaneous ultrasound guided niddle aspiration (Group A) or open surgical drainage (Group B) and results were compared. Results: Failure rate for aspiration therapy was17.14% with 06 patients requiring conversion to open surgical drainage after aspiration and were excluded from study. The resolution time was less in aspiration group. Painful and cumbersome daily changes of dressing, mammry fistula in 3 patients with ugly scar were the main drawback of open surgical drainage as compared to aspiration. However, there was high failure rate of aspiration therapy in abscesses presenting later than 5 days (45.83%) and those with >5 cm size (55.55%) on ultrasonography. Conclusion: Percutaneous ultrasound guided needle aspiration has acceptable failure rate and is an effective alternative to open surgical drainage of puerperal breast abscess especially for those present early and of small size.
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The rapidly growing nontuberculous mycobacterium, Mycobacterium fortuitum, is of increasing clinical importance. The ubiquitous M. fortuitum has been isolated from water, soil, and dust. M. fortuitum usually causes skin or soft-tissue infection following trauma or surgery, but may also infect a wide variety of tissues, including the lungs, lymph nodes, bones, joints, and meninges. We believe this is the first report of a breast abscess due to M. fortuitum, which presented in an immunocompetent woman in Korea after nipple piercing. A 26-year-old non-pregnant female presented with a 5-month history of a tender right breast lump that gradually increased in size. Pus from the right breast supported the growth of M. fortuitum. Mycobacterial infection should be considered in cases of recurrent breast abscess with sterile bacterial cultures, particularly when there is a history of nipple piercing procedures.
Subject(s)
Adult , Female , Humans , Abscess , Body Piercing , Breast , Dust , Joints , Korea , Lung , Lymph Nodes , Meninges , Mycobacterium , Mycobacterium fortuitum , Nontuberculous Mycobacteria , Skin , Soil , SuppurationABSTRACT
Breast tuberculosis is a rare form of tuberculosis (TB). In healthy individuals in developed countries, the incidence is <0.1% of breast lesions examined histologically. The significance of breast TB is due to its rare occurrence and mistaken identity with breast cancer or pyogenic breast abscess. We report the case of an 18-year-old healthy woman diagnosed with breast TB that mimicked breast abscess. She was admitted for multiple erythema nodosum (EN) of the lower extremities of 6 weeks duration. She also noticed a painful oral ulcer and a palpable nodule with fistula on the right breast for 8 weeks. Our patient had the characteristic radiological and histopathological features of breast TB. Breast abscess and EN improved after antitubercular medication, including isoniazid, rifampin, ethambutol and pyrazinamide.
Subject(s)
Adolescent , Female , Humans , Abscess , Breast , Breast Neoplasms , Developed Countries , Erythema Nodosum , Ethambutol , Fistula , Incidence , Isoniazid , Lower Extremity , Oral Ulcer , Pyrazinamide , Rifampin , TuberculosisABSTRACT
BACKGROUND: Breast abscess can be treated by needle aspiration and ultrasound can facilitate its complete drainage.OBJECTIVE: To assess ultrasonographically guided needle aspiration of breast abscesses as an alternative approach after failed initial blind aspiration.METHODS: Twenty consecutive lactating and non lactating women who were initially aspirated for breast abscess were examined with ultrasonography. Abscesses depicted at ultrasound were treated with ultrasonographic guidance, and the success of ultrasound-guided treatment was prospectively determined.RESULTS: Twenty breast abscesses were identified at ultrasound; all were treated with ultrasound guidance: One patient who was treated subsequently underwent surgical intervention; all others were successfully treated with ultrasound intervention.CONCLUSION: This case series demonstrates that sonographically guided percutaneous aspiration of breast abscesses appears to be a promising alternative to surgical incision and drainage. Its advantages include its cure rate, simplicity and apparently good cosmetic result.
Subject(s)
Humans , Female , Abscess , Surgical Wound , Lactation , Drainage , Suction , Ultrasonography , MastitisABSTRACT
Retroareolar cysts are common in pre and postmenarchic girls. Boys are rarely diagnosed with this condition. They correspond to cystic dilatations of the accessory mammary glands that open along with a sebaceous gland at the areola and can be single or multiple, uni or bilateral, palpable or incidental findings on ultrasound. They have variable morphology, thin walls, anechogenic content, sometimes calcic sediment can be observed in their lumen. Infected cysts present enlarged, hypervascularized walls; their content is echogenic, avascular and the adjacent tissue is hyperechogenic, with increased vascularization at color Doppler. If not treated, may become retroareolar abscesses. Inflamatory complications are treated with anti-inflamatory drugs and/or antibiotics. No diagnostic biopsy or puncture aspiration is required, since they are spontaneously drained at the areola. In order to appropriately advise patients and families, it is necessary to have knowledge of both the medical and the ultrasonographic aspects of them and their complications.
Los quistes retroareolares son frecuentes en niñas pre y postmenárquicas. Raramente se diagnostican en el varón. Corresponden a dilataciones quísticas de glándulas mamarias accesorias que se abren junto con una glándula sebácea en la areola, pueden ser únicos o múltiples, uni o bilaterales, palpables o hallazgos incidentales en ecografía. Los no complicados tienen morfología variable, paredes delgadas y contenido anecogénico, pudiendo observarse sedimento calcico en su lumen. Los complicados presentan paredes engrosadas, hipervascularizadas, con contenido ecogénico, avascular, tejidos adyacentes hiperecogénicos y aumento de la vascularización al Doppler color. Sin tratamiento, pueden transformarse en abscesos retroareolares. La complicación inflamatoria se trata con antiinflamatorios y/o antibióticos. No requieren biopsia diagnóstica ni punción evacuadora, puesto que se drenan espontáneamente a la areola. El conocimiento del cuadro clínico y su aspecto ul-trasonográfico permitirá orientar adecuadamente a los pacientes y sus familias.
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Breast Diseases/diagnostic imaging , Ultrasonography, Mammary , Cysts/diagnostic imaging , Nipples/diagnostic imaging , Breast Diseases/therapy , Clinical Evolution , Retrospective Studies , Cysts/therapy , Abscess , Nipples/anatomy & histologyABSTRACT
Nocardiosis is an opportunistic infection occurring in immunocompromised patients. Worldwidely, about four cases of nocardiosis of the breast have been previously reported, but none of these were in Korea. We describe a case of breast nocardiosis associated with pulmonary infection in a patient with Cushing's disease. In our patient, multiple, well-defined, conglomerated, tubular-shaped, isodense mass was revealed at mammography, and an irregular-shaped, ill-defined, heterogeneous echoic mass with movable debris at ultrasonography.