Neonatal mastitis-clinical profile and outcome: a hospital based study

ABSTRACT

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.