Breast Abcess

Lactational & non-lactational.

Lactational:

• Lactating women.
• Staphylococcus aureus.
• Pain, swelling & tenderness.
• Milk drainage from the affected segment is reduced promoting infection.
• Fluocloxacillin 500mg 6 hourly for the early stage.
• Abscess- repeated aspiration or incision- drainage.

Non-lactational Breast Infection

Periareolar infection:

Young female, smokers(90%) with underlying periductal mastitis. Presentation: Pain, peri-areolar swelling, tenderness and nipple retraction(slit)

Treatment:

• Antibiotics- Augmentin( 375 mg 8 hr.), clarithromycin+ metronidazole.
• Abscess- aspiration (small) or drainage (large)
• Recurrence common. May develop duct fistula.
• Surgical excision of the affected duct- in recurrent disease

Peripheral abscess:

Uncommon. Treated by antibiotics and aspiration/ drainage