Idiopathic ganulomatous mastitis

Casteren, Christelle Van; Jacquemyn, Yves; Himpe, Ellen; Verslegers, I.

doi:10.1136/bcr-2012-006187

Cited by 7 publications

(7 citation statements)

References 3 publications

(3 reference statements)

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“…Immunomodulator therapy may be a useful therapeutic adjunct by modifying the initial immune response and granuloma formation (22). Corticosteroid therapy in IGM is increasingly used (26)(27)(28). Further studies looking into the impact of immunomodulator treatment in cases of granulomatous breast infections are needed, with particular caution if combined with an antimicrobial regime that includes rifampin (29).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

et al. 2015

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cCorynebacterium species are increasingly recognized as important pathogens in granulomatous mastitis. Currently, there are no published treatment protocols for Corynebacterium breast infections. This study describes antimicrobial treatment options in the context of other management strategies used for granulomatous mastitis. Corynebacterium spp. isolated from breast tissue and aspirate samples stored from 2002 to 2013 were identified and determined to the species level using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), 16S RNA sequencing, and rpoB gene targets. The MICs for 12 antimicrobials were performed using Etest for each isolate. Correlations of these with antimicrobial characteristics, choice of antimicrobial, and disease outcome were evaluated. Corynebacterium spp. from breast tissue and aspirate samples were confirmed in 17 isolates from 16 patients. Based on EUCAST breakpoints, Corynebacterium kroppenstedtii isolates (n ‫؍‬ 11) were susceptible to seven antibiotic classes but resistant to ␤-lactam antibiotics. Corynebacterium tuberculostearicum isolates (n ‫؍‬ 4) were multidrug resistant. Two nonlipophilic species were isolated, Corynebacterium glucuronolyticum and Corynebacterium freneyi, both of which have various susceptibilities to antimicrobial agents. Short-course antimicrobial therapy was common (median, 6 courses per subject; range, 1 to 9 courses). Patients with C. kroppenstedtii presented with a hot painful breast mass and underwent multiple surgical procedures (median, 4 procedures; range, 2 to 6 procedures). The management of Corynebacterium breast infections requires a multidisciplinary approach and includes culture and appropriate sensitivity testing to guide antimicrobial therapy. Established infections have a poor outcome, possibly because adequate concentrations of some drugs will be difficult to achieve in lipophilic granulomata. Lipophilic antimicrobial therapy may offer a therapeutic advantage. The role of immunotherapy has not been defined. Granulomatous mastitis (GM) is a rare inflammatory condition that typically occurs in parous women of reproductive age (1). Clinically, it can present as a breast mass with features similar to those of breast malignancy (2). Multiple infective and inflammatory conditions, including tuberculosis (TB), fungal infections, sarcoidosis, amyloidosis, and Wegener's granulomatosis, have been recognized, but recently, attention has been drawn to corynebacterial species as a specific pathogen in this disease. Typically, corynebacterial breast infections are characterized by abscess formation, granulomatous inflammation, and progression to sinus/fistula formation (3). This and other specific diagnoses should be excluded before a diagnosis of idiopathic granulomatous mastitis (IGM) is made (3-5).Commonly, it is the lipophilic species of the Corynebacterium genus that cause mastitis (3, 6-8). As such, a microbiological diagnosis can be challenging, due to their fastidious growth requirements and prolonged incu...

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

et al. 2015

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“…IGM is characterized by the presence of epithelioid and multinucleated giant cell granulomas limited to the mammary lobules with micro-abscesses in the absence of obvious etiology [16]. Local or systemic irritants as well as undetected infective causes may result in damage to the ductal epithelium.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous mastitis: A retrospective review of 49 patients

Gırgın¹,

Uslukaya²,

Yılmaz³

et al. 2015

Dicle Med J

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İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme kanserini taklit eder. Bu çalışmada idiopatik mastitli 49 hastanın tedavisini ve kliniğini sunmayı amaçladık. Yöntemler: Hastane otomasyon sisteminde 2007-2012 yılları arasında histolojik olarak granulomatöz tanısı konulmuş hastalar incelendi. Hastalara ait klinik bulgular, demografik veriler ve tedavi yöntemleri kaydedildi. Bulgular: Ortalama yaş 37.71±7.1 idi. Tedavi gruplar arasında etiyolojik ve demografik açıdan istatistiksel fark yoktu. Nüks oranları grup 1, grup 2 ve grup 3'te sırasıyla %8,3, %14,8 %20 olup, gruplar arasında istatistiksel anlamlı farklılık yoktu. Sonuç: Steroid ve cerrahi tedavinin idiopatik granulomatöz mastitli hastalarda uygulanabileceğini, steroid tedavisinin ilk basamak tedavi olması gerektiği kanaatindeyiz. Bununla birlikte tedavi algoritması belirlenebilmesi için prospektif, randomize klinik çalışmalara ihtiyaç vardır.

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“…Respected specimen is sent for histopathological examination along with bacilli and fungal detection by staining and PCR. In most of the cases, wide local excision suffices but mastectomy is required in extensive and recurrent lesions [8]. Complications include skin ulceration, fistula formation, disfigurement and recurrence.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic granulomatous mastitis: a great diagnostic challenge

Singla¹,

Rana²,

Thami³

et al. 2014

IJPBR

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Keywords:Granulomatous mastitis, AFB, Mastectomy, Tuberculosis breast, ABSTRACTIdiopathic granulomatous mastitis is a rare chronic inflammatory lesion of breast which presents as a spectrum of diseases and is diagnosed only histological. It is often a diagnosis of exclusion in most of the cases. Medical and surgical treatments have been tried with varied success rates and till today no standard protocol could be made in its management though excision remains the treatment of choice in refractory cases which is associated with morbidity more due to psychological factors. In the present case, medical treatment was tried in the initial phase followed by wide excision.

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Idiopathic ganulomatous mastitis

Cited by 7 publications

References 3 publications

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

Granulomatous mastitis: A retrospective review of 49 patients

Idiopathic granulomatous mastitis: a great diagnostic challenge

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