Gynecology And Obstetrics-

mastitis

introduction

Breast infections are particularly common during pregnancy or breastfeeding.

In addition, it can also lead to an inflammation of the breast, in the absence of pregnancy. The symptoms show typical signs of inflammation, although the symptoms are often more pronounced in breastfeeding mothers. If a breast infection occurs, it is advisable to consult a doctor.

Overview of symptoms

Depending on the cause, breast infections can have different symptoms. Typical complaints include:

fever
General feeling of illness (tiredness / fatigue)
Pain and tension
Redness
Swelling
Chest overheating
Swelling of the lymph nodes
node
altered breast milk

In many cases, inflammation of the breast leads to the development of inflammatory processes in the area of the mammary ducts. For this reason, young mothers are particularly often affected. This type of breast infection usually occurs one to two weeks after the birth of a child and is known as puerperal mastitis. Symptoms of a breast infection often include a high fever and a general feeling of illness. In addition, pain, which usually occurs strictly on one side in the affected chest, is one of the most common symptoms, as well as a significant overheating of the tissue.

Swelling of the affected breast as well as burning of the nipples and a visible reddening of the breast can also be observed. The typical symptoms of breast inflammation outside of breastfeeding, so-called mastitis non-puerperalis, are less pronounced than with breast inflammation during breastfeeding. While breast inflammation can usually be treated well during breastfeeding and is characterized by a rapid decrease in symptoms, non-puerperal mastitis tends to recur.

In addition, a breast abscess can develop in the course of a breast infection. This is an encapsulated collection of pus caused by the inflammatory processes. Such changes usually present themselves as palpable hardening of the breast tissue.

Read more on the topic: Inflammation of the chest

fever

Fever is a typical symptom accompanying a breast infection. The body reacts to the source of inflammation by raising the body temperature to kill pathogens. This is a sign of the immune reaction taking place. If the breast inflammation is mild, the fever may also be absent.

The affected breast is then only painful, red and possibly swollen. However, if the disease is more severe, it usually leads to a higher fever. With appropriate treatment of the inflammation, the fever usually subsides quickly and the woman can recover.

node

If you have a breast infection, you can feel a hard lump in the affected breast. In addition, the corresponding area is usually swollen, red and very painful. A lump is therefore a typical finding in a breast infection. It is caused by the inflammatory reaction of the glandular tissue. In addition, the lymph nodes in the armpit on the corresponding side often swell, so that nodes can also be felt there. When the breast inflammation is treated and the symptoms subside, the lump also recedes.

A lump in the breast should always be observed and clarified by a doctor, as benign or malignant growths can be hidden behind it. Therefore, if you have symptoms like this, you should definitely consult a gynecologist who can then decide on how to proceed.

Read more about this at: Breast lump

Non-puerperal mastitis

Mastitis non puerperalis is an acute inflammation of the female mammary gland which can have both bacterial and abacterial causes. In contrast to puerperal mastitis, non puerperal mastitis develops independently of pregnancy and the puerperium. Mastitis non puerperalis accounts for up to 50 percent of all breast infections.

The most common pathogens of the bacterial form of mastitis non puerperalis staphylococci. This form of breast inflammation is favored by various diseases that make it easier for the bacterial pathogens to enter the mammary gland tissue. The spontaneous leakage of breast milk from the mammary gland tissue (galactorrhea), for example, plays a special role in the development of breast inflammation.

The abacterial form of mastitis non puerperalis is in most cases caused by hormonal, drug-induced or stress-related hyperprolactinemia. In the course of this disease, the affected women experience increased secretion from the end pieces of the glands and an associated congestion of the milk. The mammary gland tissue reacts to this congestion with a reflex expansion of the milk ducts (Ductectasis), which in turn can lead to the milk escaping into the surrounding tissue. For the organism, this is ultimately a stimulus that can cause inflammatory processes. Basically, this form of breast inflammation is a classic foreign body reaction. There are specific risk factors associated with the occurrence of breast inflammation, including: smoking, expired breastfeeding period and damage to the glandular tissue.

What are the symptoms of mastitis non puerperalis?

The symptoms of mastitis non puerperalis typically correspond to the symptoms of any inflammatory process. In the affected women, a significant reddening of the breast surface can be noticed after a short time. In addition, the inflammatory processes occurring inside the breast tissue cause the affected breast to overheat. In addition, women suffering from non puerperal mastitis notice a progressive swelling in the area of the affected breast.

When palpating the mammary glands, a diffuse, coarse infiltrate is usually noticed. Depending on the severity of the breast inflammation, the pain will vary in intensity. Since mastitis non puerperalis is often an acute infection, in around 50 percent of cases there is also a swelling of the armpit lymph nodes on the affected side of the body.

In contrast to puerperal mastitis, the patients often do not suffer from any pronounced general symptoms (e.g. fever and chills).

Puerperal mastitis

This most common form of breast inflammation usually occurs about 2 weeks after birth due to the immigration of bacteria (mostly staphylococci) from the baby's mouth to the breast. The entry point for the bacteria are small cracks on the nipples or the milk ducts themselves.

Please also read our page Maternal Problems During Breastfeeding.

Symptoms of mastitis non puerperalis

In addition to the symptoms of breast inflammation (Non-puerperal mastitis) such as redness, heat and painful swelling of the chest, there is also a massive reduction in the general condition with fever. You can usually see significant changes in breast milk. These changes are mainly caused by the disturbance of the mammary secretions. When breast inflammation is present, increased numbers of certain cells can be detected in breast milk. In the case of infection-related forms of inflammation of the mammary gland, the lymph nodes surrounding the breast also usually become involved. In most patients these are enlarged and tend to be tender. Because of the pain caused by the inflammation, breastfeeding is usually severely restricted or even impossible for the affected mothers.

Therapy of mastitis

Antibiotics should be used for the bacterial form of breast inflammation. If the breast infection has already turned into an abscess, this must be surgically opened.

Both forms (bacterial and not bacterial) so-called prolactin inhibitors are administered to mastitis non puerperalis, which curb the hormonal disorder and thus the excessive milk secretion. The intake must take place over several weeks. If there is no improvement after a few days, the presence of a special type of breast cancer (inflammatory breast cancer) because she shows the same symptoms as the Mastitis non puerperalis.

Since relapses are common, the therapy should be continued for a long enough time and risk factors such as continued milk secretion after breastfeeding should be eliminated.

Treatment of non-pueperalis mastitis

The treatment of mastitis non puerperalis is mainly symptomatic. If the pain symptoms are pronounced, pain relievers such as ibuprofen or paracetamol can be taken. In the symptomatic treatment of mastitis non puerperalis, ibuprofen has the advantage that, in addition to its pain-relieving effect, it can also have an inhibiting effect on the inflammatory processes occurring inside the mammary gland tissue. This is not possible when taking paracetamol.

The bacterial form of mastitis non puerperalis is also treated with the help of antibiotics.

If there is an abscess, it must be surgically opened and completely removed. The abacterial form of mastitis non puerperalis is often treated by administering prolactin inhibitors.

Treatment of pueperalis mastitis

The breast inflammation should be treated with antibiotics as quickly as possible, as it is no longer accessible to antibiotic therapy in the advanced stage of abscess formation. In that case come Prolactin inhibitors (see above) and / or heat therapy with red light is used. Surgical opening of the abscess may also be necessary. In addition, cooling the chest can provide relief. The milk should be discarded during breast inflammation as it contains germs. After the inflammation subsides, breastfeeding can be resumed in most cases.

Home remedies for a breast infection

Various home remedies have been used more often in the past to treat breast infections. Mention should be made here of the use of heat before breastfeeding and the application of cold, for example with cool quark compresses after breastfeeding. This improves the flow of milk, stimulates the tissue to swell and thus reduces the cause of the inflammation.

Another home remedy that helps relieve symptoms in a similar way to quark compresses are white cabbage compresses that are placed on the chest in a cool place.

During breastfeeding, an important tip for improving breast infections is regular breastfeeding so that the breast can be relieved several times a day. If breastfeeding is not possible, the use of breast pumps can be helpful. The right system technology is also important for prevention.

homeopathy

In homeopathy, breast inflammation is also a well-known clinical picture, which is treated with globules. There are various plants and dilutions available for this, which are individually adapted to the appearance of the breast inflammation. The globules used most frequently contain parts of the plants Belladonna, Hepar sulfuris, Bryonia and Phytolacca. But other globules can also be used in the treatment.

Read our topic on this: Breast inflammation and homeopathy

forecast

The prognosis of breast inflammation depends primarily on the form of the patient. In addition, the time of diagnosis and the initiation of therapy play a decisive role in this context.

A breast infection that is directly related to breastfeeding usually has a good prognosis. In particular, mild forms of puerperal mastitis heal completely in many cases without medical intervention. In addition, breast inflammation caused by breastfeeding responds well to antibiotic treatment in most people. With an early diagnosis and prompt initiation of a suitable therapy, the symptoms felt by the affected patient recede quickly, even with pronounced forms of the disease.

However, the prognosis for breast inflammation worsens if an abscess has already developed within the breast tissue. If an abscess has already become encapsulated in the affected patient, the attending physician must open and remove it during a small, outpatient surgical procedure.

The healing time of breast inflammation is significantly extended in these cases. If the abscess that develops in connection with a breast inflammation is not opened properly, there is a risk that the abscess cavity will spontaneously open inwards and the bacterial pathogens enter the bloodstream. This may lead to blood poisoning (sepsis) to lead. The prognosis of breast inflammation worsens significantly in these cases.

Breast inflammation that occurs unrelated to breastfeeding a newborn child has a significantly worse prognosis than classic puerperal mastitis. The reason for this is the fact that in many cases non-puerperal mastitis tends to return again and again (recurrent course of the disease). In this context, in order to assess the prognosis of breast inflammation, it is essential to find the cause of the recurring inflammatory processes. Targeted treatment of this cause and the elimination of possible risk factors can significantly improve the prognosis.

Inflammation of the breast in men

Breast inflammation can also occur in men if the mechanical stimulus or stressed skin on the chest becomes the gateway for bacteria. Here, abrasive clothing can be a sufficient trigger. But dry skin can also cause breast inflammation in men.

At the onset of symptoms, a doctor should be seen to prevent the inflammation from getting worse and to treat it adequately early.If inflammations of this type often return without a directly evaluable trigger, there may also be a serious cause behind it, such as certain hormonal disorders or metabolic diseases, which should be clarified by a doctor.

causes

Inflammation of the breast after an operation

After an operation on the breasts, breast infections can occur. During the operation, the skin is severed so that germs can get into the tissue. This can lead to an inflammatory reaction.

A breast infection can also develop if the surgical wound is not adequately cared for and bandaged after the operation has been completed. First of all, a sterile bandage is applied to the wound, so that no germs can enter through the suture and the operating area is optimally protected against contamination. If there is redness, swelling and pain in the operated breast, it must be assumed that it is inflamed and appropriate therapy initiated in order to avoid complications.

Milk congestion

A milk blockage can present with symptoms similar to those of a breast infection. Nevertheless, there are different clinical pictures that should not be confused.

If the breast is blocked, the affected breast has hardened and painful areas. There may also be reddening. However, the pain is usually less pronounced than with a breast infection. In addition, breast inflammation is often accompanied by fever and a general feeling of illness.

A pronounced congestion of the milk can eventually turn into a breast infection. It is therefore important to differentiate clearly between the two clinical pictures and to initiate the appropriate therapy at an early stage.
In contrast to breast inflammation, antibiotic treatment is not yet necessary for a milk blockage. The milk blockage usually resolves itself within one to two days. The woman should try to stroke the affected breast while breastfeeding and consciously continue to lay the child against this breast.

Read more on the topic: Milk Obstruction - What Can You Do?

Breast inflammation and pregnancy

The breast infection is one typical complication of the puerperiumwhen the mother is breastfeeding her child.

In the pregnancy is the breast infection less common, but can also occur. Through small cracks in the skin you can Germs enter the chest and cause inflammation there. However, especially during pregnancy, the Secretion and milk production have been stimulated in the mammary gland by changing the hormonal balance, so that this liquids in the gland ducts accumulate can. Since the mother is not yet breastfeeding, a Milk congestion develop, which can lead to inflammation of the corresponding breast.

However, breast infection can occur in pregnancy too other causes have, for example, a Hormone imbalance as a result of stress, medication or other previous illnesses. It is therefore always important that root cause the breast infection clarify with a doctor so that the individually appropriate therapy can be initiated.

You may also be interested in this topic: Breast pain in pregnancy

Breast inflammation while breastfeeding

Breast inflammation during breastfeeding (Puerperal mastitis) is a common complication in mothers that can be caused by a variety of causes. Since the breast tissue changes during pregnancy as a result of hormonal influences, the female breast becomes able to supply the baby with milk after birth. If there is a blockage of the breast due to flow obstruction, it can become inflamed, which manifests itself as swelling, reddening, tenderness and pain. In order to prevent this complication during breastfeeding, it is particularly important to regularly empty the breast and carefully spread out congested areas with your hands so that the milk can drain off there too.

Another cause of breast inflammation during breastfeeding can be mechanical stress from the infant's mouth. Since the sucking reflex causes the finest cracks in the skin of the breast, bacteria can sometimes infiltrate the damaged skin, which can then become inflamed.

Nipple inflammation

Nipple inflammation is a sub-form of breast inflammation, which can have different causes. The entry of germs into the skin of the nipple can cause inflammation.

However, non-bacterial nipple inflammation is also possible, which in the worst case can be a symptom of a malignant event. Much more common, however, is the cause of the mechanical stress, for example from breastfeeding.

Read more on the topic: Nipple inflammation

Breast inflammation caused by a nipple piercing

Unsterile conditions before, during or after performing a breast piercing can also cause bacteria to get into the pierced skin. This can lead to the development of an inflammatory process that, like other causes of breast inflammation, manifests itself in pain, redness, pus, swelling and sensitivity to touch.

If inflammation occurs from a nipple piercing, the piercing must be removed and the wound surface treated with antibacterial properties. Antibiotics or, in extended cases, the insert of a tab for daily rinsing of the inflamed area may be necessary.

diagnosis

The diagnosis of mastitis non puerperalis takes place in most cases by questioning the patient concerned. Above all, the symptoms perceived by the patient play a decisive role in the diagnosis of mastitis non puerperalis.

If after an extensive doctor-patient conversation (anamnese) If there is a suspicion of a breast infection, further measures can be taken. In the diagnosis of mastitis non puerperalis, the examination of the mammary gland tissue by means of ultrasound and mammography plays a decisive role.

The most important differential diagnosis of mastitis non puerperalis is the so-called "inflammatory breast carcinoma", in which the typical signs of inflammation also develop.