Mastitis

Mastitis occurs most commonly during breast feeding and lactational mastitis is discussed seperately.

Breast infection can also occur at other times.

Symptoms include redness, tenderness and warmth in the breast.

Antibiotics are effective treatment at this early stage.

Flucloxacillin is usually effective and for those with possible Penicillin allergy, Erythromycin is a reasonable alternative.

If there is no improvement within 48-72 hours of starting antibiotic therapy ultrasound examination should be arranged to exclude an abscess. This is the most common explanation for a poor response to antibiotics and is due to a collection of pus forming in the breast tissue. The antibiotics cannot penetrate into the abscess cavity and drainage of the pus will improve the situation very quickly. (see breast abscess below)

Other less common causes for a poor response to antibiotics include fat necrosis, inflammatory cancer, unusual infections such as TB and granulomatous mastitis.

Triple assessment including appropriate imaging and biopsy is necessary to exclude these problems in anyone who does not respond to antibiotic therapy within a few days.