Nipple inflammation

Introduction Milk hair inflammation is common in acute inflammation of the breast. Most of them have nipple pain, rupture or breast lumps, pain, and then cold, chills, and fever. The affected side of the breast is tender, the skin is red, swollen, the skin temperature is elevated, the subcutaneous mass or the skin is not red, not swollen, not hot, the block is deep, and the skin is not connected, but the pain or tenderness is severe.

Cause

Acute mastitis is an acute suppurative condition of the breast, usually caused by Staphylococcus aureus infection. More common in the primipara breastfeeding period. Bacteria can invade from the nipple breakage or cleft palate, or directly invade the milk duct and spread to the mammary gland. In general, acute mastitis has a short course and a good prognosis, but if it is not treated properly, it will delay the course of the disease, and may even be complicated by systemic suppurative infection.

an examination

Related inspection

Mammography X-ray examination blood routine chest B-ultrasound

1 According to clinical typical symptoms and signs, it can be diagnosed.

Acute mastitis at the beginning of the affected side of the breast fullness, pain, especially during breastfeeding, milk secretion is not smooth, breast agglomeration with or without, systemic symptoms can not be obvious, or accompanied by general malaise, poor appetite, chest tightness, irritability, etc. . Then, the local breasts become hard and the mass gradually increases. At this time, there may be obvious systemic symptoms such as high fever, chills, general weakness, dry stools, and the like. Abscess can often form within 4 to 5 days, breast pulsation pain can occur, local skin is red and swollen, and translucent. When the pus becomes pus, the center of the mass becomes soft, and there is a sense of fluctuation. If the breast is deep abscess, swelling of the whole breast, pain, high fever, but local skin redness and fluctuations are not obvious, need to be diagnosed by puncture. Sometimes there may be several abscesses, or they may be formed at different times, and the skin may be worn or penetrated into the milk duct to allow the pus to overflow from the nipple. After the rupture of the pus, the pus leads to a smooth flow, which can reduce the pain and reduce the pain. If the treatment is not good, the time is wrong, the abscess may wear the connective tissue before the pectoralis major fascia, forming a post-abdominal abscess; or the milk will overflow at the mouth of the mouth to form a milk leak; severe cases may occur sepsis. Acute mastitis is often accompanied by swelling of the affected axillary lymph nodes, tenderness, increased total white blood cells and neutrophils.

2. Blood examination: The total number of white blood cells and neutrophils were significantly increased.

3. Detecting masses, should be puncture under local anesthesia, help the diagnosis of abscess.

4. B-ultrasound can help diagnose abscesses.

Differential diagnosis

Hair dermatitis needs to be differentiated from the following symptoms:

1. Lactating traumatic hematoma

There are often lumps, local swelling and pain, but there is a history of trauma, no obvious systemic symptoms of infection, the puncture of the tumor into the blood can confirm the diagnosis. A traumatic hematoma during lactation is prone to secondary infection and forms acute mastitis.

2. Breast cancer

There is a highly malignant inflammatory cancer in breast cancer. Its performance is similar to that of breast inflammation. There are red, swollen, hot and relatively mild pains in the breast. The clinical often cannot buckle the mass. Suppuration, systemic response is light and the total white blood cell count and neutrophil count are not high, antibiotic treatment is ineffective. There are some breast cancers that occur during lactation and pregnancy. They are hidden in physiologically enlarged breasts and can easily be mistaken for milk deposits. Failure to pay sufficient attention requires audiological and imaging examinations to help determine.

3. Plasma cell mastitis

It is a ductal dilatation of the breast, which often occurs in non-breasting and non-pregnancy, and the breast has inflammation, but the course is longer, ranging from several months to several years. The development is slow, and the nipple can squeeze out acne-like substances with odor. Many patients There are nipple retractions, the condition often occurs repeatedly, and some form a small abscess, often formed after the collapse of the fistula, and the wound is repeatedly broken after healing.

4. Acute viral mastitis

In addition to this acute bacterial mastitis, acute viral mastitis occurs, but it is rare, generally considered to be a complication of acute mumps, characterized by swelling of the double breast, local red heat Even, it will not purulent, the total number of white blood cells is normal or slightly lower, the lymphocyte count is relatively increased, and often healed with the recovery of mumps.

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