Mastitis in early infancy

Abstract

Aim: To evaluate the clinical features and microbiological findings in young infants with mastitis. Methods: Retrospective review of medical records of 18 infants with breast inflammation during the first 3 mo of life seen in the paediatric emergency department between 1992 and 2002. Results: All were full‐term infants with female–male ratio of 3.5∶1. The age ranged from 12 to 45 d, with a peak in the 4th and 5th weeks of life. Only five patients had systemic manifestations, and five were pretreated with oral antibiotics (amoxicillin‐clavulanic acid). The latter as well as seven additional cases required incision and drainage due to abscess formation. Bacterial cultures grew Staphylococcus aureus in 10 cases including all pretreated infants. In four of these cases, Gram stain showed the pathogen. After antimicrobial treatment, no recurrence was observed in any of the patients. Conclusions: These findings suggest that mastitis in early infancy should be treated with parenteral antibiotics guided by Gram stain when available and informative. Otherwise, β‐lactamase‐resistant antibiotics are a reasonable empirical initial treatment pending culture results. Optimizing the management of infants with mastitis is important especially since abscess formation requiring incision may be detrimental for later breast development.

Nonpuerperal mastitis in adolescents

“…1,7 It is therefore reasonable to treat adolescents with mastitis with antibiotics active against S aureus. This study shows that, as opposed to infants with mastitis who should be treated with parenteral antibiotics, 8 in adolescents oral treatment often suffices. In cases of abscess formation, incision and drainage are necessary.…”

“…In cases of abscess formation, incision and drainage are necessary. The rate of abscess formation in adolescents is lower than in neonates, 8 probably due to anatomic and/or immune factors.…”

A Neonatal Breast Abscess Due to Pseudomonas aeruginosa: Case Report

“…En sık etken S. aureus'tur (1,(7)(8)(9)(10) . Gram negatif enterik mikroorganizmalar (Escherichia coli, Proteus mirabilis, Salmonella türleri, P.aeruginosa gibi) daha az sıklıkta görülür.…”

“…Mastitin en sık görülen klinik bulguları şişlik, kızarıklık ve ısı artışı olup, nadir de olsa olgumuzda olduğu gibi fluktuasyon bulgusu olan apseye dönüşebilir (7,8) . Ultrasonografi ile mastit ve meme apsesi ayrımı yapılabilir (16) .…”

Long-term consequences of neonatal mastitis

“…In cases of breast abscess managed by incision and drainage, scarring and breast asymmetry, with the previously affected breast being significantly smaller, has been reported 2. In a review of 39 infants with breast abscess, two out of six girls available for follow up at 8–15 years of age were noted to have decreased breast tissue on the affected side 3…”