Puerperal mastitis

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 retrograde 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)

Radiographic features

  • not usually 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

Differential diagnosis

Neoplasm should be suspected if the condition does not improve with antibiotic therapy.

Breast imaging and pathology
Edit Article Share Article

Article Information

rID: 26001
System: Breast
Section: Pathology
Tags: breast, cases
Synonyms or Alternate Spellings:
  • Mastitis of pregnancy and lactation
  • Mastitis during breast feeding

Updating… Please wait.


Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.