Puerperal mastitis refers to mastitis occurring during pregnancy and lactation.
It occurs most often during breast feeding and is rarely encountered during pregnancy.
The source of infection is the nursing infants nose and throat; the organisms being Staphylococcus aureus and Streptococcus. Due to a breach in the nipple areola complex such as a cracked nipple, there is rerograde dissemination of these normal commensals. This is further favoured by stasis of milk as stagnant milk is an excellent medium for bacterial growth.
Staphylococcus aureus infections tend to be more invasive and localised leading to earlier abscess formation; while Streptococcus infections tend to present as diffuse mastitis with focal abscess formation in advanced stages.
- endemic/sporadic: majority of the cases
- epidemic type: less common; can be life threatening and is related to methicillin resistant Staphylococcus aureus (MRSA)
- not ususally done
- skin and trabecular thickening due to breast oedema
- abscess may be seen as ill-defined mass
- primary modality of choice
- abscess: irregular, hypoechoic to anechoic mass with fluid and debris and posterior acoustic enhancement.
- mastitis: ill-defined, hypoechoic region
- periductal inflammation
- guidance for abscess drainage
Treatment and prognosis
- antibiotic therapy
- drainage of abscess
Neoplasm should be suspected if the condition does not improve with antibiotic therapy.
- 1. Sabate JM, Clotet M, Torrubia S et-al. Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics. 2007;27 Suppl 1 (suppl_1): S101-24. doi:10.1148/rg.27si075505 - Pubmed citation
- 2. Cantlie HB. Treatment of acute puerperal mastitis and breast abscess. Can Fam Physician. 2012;34: 2221-6. Free text at pubmed - Pubmed citation
- 3. Hager WD, Barton JR. Treatment of sporadic acute puerperal mastitis. Infect Dis Obstet Gynecol. 1996;4 (2): 97-101. doi:10.1155/S106474499600021X - Free text at pubmed - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Mastitis of pregnancy and lactation||✗|
|Mastitis during breast feeding||✗|