Mastitis

Introduction to mastitis Mastitis is an acute suppurative infection of the breast. It is a common disease in the puerperium and one of the causes of postpartum fever. It is most common in breastfeeding women, especially primipara. It can occur at any time during lactation, and the beginning of breastfeeding is most common. The incidence of primiparas in acute mastitis is 50%, and the ratio of primipara to maternal is 2.4:1. It can occur at any time during lactation, but it is most common in 3 to 4 weeks after birth, so it is also called mastitis during puerperium. basic knowledge Probability ratio: 19% probability of breast-feeding women Susceptible population: Most common in breastfeeding women, especially primipara. Mode of infection: non-infectious Complications: sepsis and bacteremia

Causes of mastitis

The nipple is too small (20%):

The nipple is too small or invaginated, hindering breastfeeding, and the pregnant woman fails to correct the nipple retraction in time before birth, and it is difficult for the baby to suck.

Excessive milk (20%):

Excessive milk, emptying is not complete, the mother did not promptly empty the excess milk in the breast.

The milk duct is blocked (15%):

The milk duct is blocked, the milk duct itself is inflamed, the tumor is externally oppressed, and the fiber that the bra is detached can also block the milk duct.

Nipple retraction causes difficulty in sucking breasts (25%):

Infants are difficult to suck, which is easy to cause damage around the nipple. This is the main way for bacteria to infect along the lymphatic vessels.

Babies often sleep with nipples (20%):

If the child has oral inflammation, the bacteria can directly invade the milk duct, and then spread to the mammary gland, causing a purulent infection.

Mastitis prevention

1. Avoid milk accumulation.

2, to prevent nipple damage, timely treatment when there is damage.

3, do not give children the habit of sleeping with nipples.

Many mothers are used to feeding their children with nipples when they are breastfeeding their children. This is an important cause of mastitis in lactating women.

4, massage massage during pregnancy: pregnancy 6 months or so will start the above massage method, daily adherence, not only can smooth the breast, so that lactation reduces pain, but also can reduce the incidence of mastitis and breast cancer after breastfeeding.

Mastitis complications Complications sepsis and bacteremia

1. Sepsis and bacteremia

The course of the disease enters the stage of acute suppurative mastitis. The patient may have sepsis and bacteremia. At this time, the patient continues to have high fever, flushing and phlegm, and metastatic abscess may occur.

2. Breast fistula

The pus abscess can be ruptured inward or outward, forming a skin rupture and a breast fistula. If improperly treated, it can form long-term unhealed purulent sputum or chyle. It can be seen that the milk and pus are discharged from the fistula.

Symptoms of breast inflammation Common symptoms Breast redness, heat, pain, nipple peeling, breast pain, breast pain, chills, high fever, abscess

Pain

In the early stage of acute simple mastitis, it is mainly the pain of the breast, the local skin temperature is high, the tenderness, the inconsistency of the boundary is unclear, and the tenderness.

2. Symptoms of inflammation

Acute suppurative mastitis local redness, swelling, heat, pain, obvious induration, tenderness, can be accompanied by chills, high fever, headache, weakness, pulse fast and other systemic sinus, and axillary lymph nodes, tenderness.

3. Abscess

Due to ineffective treatment or further aggravation of the disease, necrosis and liquefaction of local tissues occur, and infections of different sizes merge to form an abscess. The abscess can be single-atrial or multi-atrial. Superficial abscesses are easily detected, while deeper abscesses are not obvious and are not easy to detect. If the systemic symptoms of patients with mastitis are obvious, and the effects of local and systemic drug treatment are not obvious, it is necessary to pay attention to the puncture of the pain site, and the white blood cells are found in the pus or smear to confirm the diagnosis of the abscess.

Mastitis examination

1. Blood routine: white blood cells can be elevated.

2. B-ultrasound: no obvious changes, the formation of abscess in the late stage. White blood cells are found in the fluid or smear to confirm the diagnosis of abscess.

Diagnosis and differentiation of mastitis

Disease diagnosis

1 Most of the patients are lactating women, especially those with primipara, and there is a history of nipple cleft palate and history of poor milk accumulation before onset.

2 local symptoms: breast redness, heat, pain and suppuration. The affected axillary lymph nodes may be swollen.

3 systemic symptoms: chills, high fever, irritability, fatigue, dryness and so on.

4 laboratory tests: white blood cell count increased, especially the number of neutrophils increased significantly. Local aspiration during suppuration may have purulent secretions.

Differential diagnosis

Acute mastitis

It usually occurs in a certain segment of the breast, and inflammatory breast cancer cells infiltrate the reticular lymphatic vessels extensively, so the lesions involve most of the breasts, and the skin has an orange-like appearance.

2. Inflammatory breast cancer

The breast can reach a huge mass, and the skin has a wide range of redness and swelling, but the local tenderness and systemic poisoning symptoms are relatively light. Puncture cytology can find cancer cells to confirm the diagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.