Neonatal mastitis is rare and refers to infection of the breast tissue occurring in a neonate.
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Clinical presentation
Patients may present with unilateral breast erythema and pain sometimes with associated nipple discharge and lymphadenopathy. It usually occurs in patients under five weeks of age, with a peak incidence around three weeks of age. Systemic symptoms, such as fever, are not always present.
Pathology
Neonatal breast hypertrophy is common in newborns, which is thought to be from declining levels of maternal estrogen triggering neonatal prolactin secretion. Superinfection of this breast tissue results in mastitis.
The most common causative organisms are Staphylococcus aureus (83-88% of cases), Escheria coli, Salmonella spp., anaerobes and Group B streptococcus.
Radiographic features
Ultrasound
poorly defined hyperechoic breast tissue with hyperemia with surrounding hypervascular, hyperechoic subcutaneous fat
abscesses may appear as avascular hyperechoic or anechoic areas with surrounding hyperemia
Treatment and prognosis
Oral or parenteral antibiotic therapy is usually required.
Complications
breast abscess formation is the main complication from neonatal mastitis; incision and drainage may be necessary in these complicated cases
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