Mastitis

Mastitis (synonym of grudnia) is an inflammation of the breast. More often seen in lactating women, but can occur in pre-Natal period, as well as in non-lactating women and girls rarely in men (see Gynecomastia.) Pathogens mastitis - pyogenic bacteria (most often, staphylococci), penetrate into the fabric of cancer through the lymphatic ducts or dairy moves through nipple cracks, abrasions, scratches on the skin. Of great importance in the development of mastitis is the stagnation of milk.
There are the following forms of clinical mastitis: acute serous, infiltrative, abstemiously, flegmona, gangrenous) and chronic inflammatory.
Serous form of acute mastitis characterized by the appearance of mild pain in the breast, elevation of body temperature up to 39-40°, increased cancer. At a palpation is determined by a uniform seal and pain cancer. Cessation of breastfeeding or pumping can lead to the rapid development of mastitis.
Infiltrative form of mastitis develops in case of improper or untimely treatment of primary, serous, form of the disease.
Characterized this form sharp pain in the breast, further fever, chills. There are redness of the skin, increase the size of cancer, inflammation and swelling. Palpation is determined painful infiltrate vague no signs of softening and fluctuations (see Zublena).
Regional lymph nodes are not enlarged, blood leukocytosis (10 000-12 000), accelerated ROHE.

mastitis (abstemiously form)
Localization of abscesses, mastitis: 1 - surface about-liners region; 2 - the delay of pus in the dairy course; 3 - deep abscess in the thickness of cancer; 4 - pugachyovsky and backwards from him retromammary abscesses.

Abstemiously form (Fig) Mastitis develops from infiltrative in the absence of the effect of the therapy. There are shivering with fever, regional lymphadenitis, redness of the skin of the breast, in the centre of infiltration softening in connection with the formation of an abscess.
Flegmona form of mastitis occurs with the sharp deterioration of the General condition of the patient. Growing phenomena of intoxication, the number of cells increases to 17 000-20 000, ROE reaches 60 - 75 mm per hour, the content of hemoglobin decreased up to 40-45%. In urine appear protein, a single red blood cells, granular and hyaline cylinders. Mammary gland swollen, hyperemic, leather lunatica, brilliant, retracted nipple, is palpated several centers of softening. There are phenomena of lymphangitis (see) and lymphadenitis (see).
Complications purulent mastitis: sepsis, haemorrhage as a result of erosion (corrosive) vessels, retromammary abscess.
Gangrenous form of mastitis has been observed in patients late seeking medical treatment or for especially serious infection that occurs with the development of necrotic process in the breast. The condition of patients is extremely heavy, with symptoms of severe intoxication, temperature 40-41 degrees, the leukocytosis 20 000-25 000 with a sharp shift to the left, the hemoglobin decreases to 25%, ROE increased to 60-70 mm per hour. Urine protein, erythrocytes, hyaline and granular cylinders. The skin over the breast dark-brown, sometimes with a blackish hue, covered with bubbles in individual sectors skin necrosis. Nipple retracted, the milk is missing; the regional lymph nodes are enlarged, painful.
Chronic inflammatory mastitis is often a consequence of severe, but sometimes it is primary. The mammary gland is enlarged in volume, at a palpation it is very dense (cartilage density) infiltration, not associated with skin, little painful. The skin over the infiltration is not changed. Temperature is normal or slightly increased, sometimes palpable enlarged lymph nodes. This form of mastitis is not easy to differentiate from breast cancer.
Initial forms of mastitis should be differentiated from milk stagnation, rojistoe inflammation of skin cancer, surface lymphangitis. In these cases, there is no infiltration tissue of the breast, lactation fully preserved. In doubtful cases, especially with infiltrative form of mastitis, not getting treatment (possible breast cancer!), feldsher and midwife are required to send the patient to consult a surgeon or in Oncology clinic.
Prognosis with proper treatment of mastitis favorable. Timely treatment of serous mastitis leads to recovery in a few days. At a superficial abscesses, revealed themselves or by surgery, the process ends within 7-15 days; in severe cases, as well as in the deep, widespread process in the weeks and even months.
The comprehensive treatment of mastitis. At the beginning of the disease it is important to prevent the stagnation of milk (breast-feeding a patient's chest, careful sucking milk breast pumps pumping), used in turning 2-3 days cold on the mammary gland, prescribe laxatives (better salt), limit the introduction of liquid (up to 1 liter per day). For the prevention of venous stagnation of the breast should be lifted using scarves or tight bandages. When the temperature - antibiotics (penicillin 300 000 IU 4 times a day in combination with streptomycin - 500 000 UNITS, 2 times a day), sulfa drugs (but 1 g 4 - 5 times a day). In the acute phase of infiltration additionally shows the physical treatment methods (quartz, UHF, sollux), the introduction of penicillin procaine under the infiltration and in the surrounding tissue. At a superficial abscesses - opening the abscess. The surgery can be performed as an outpatient physician under local anesthesia novocaine or by chloroethyl with observance of aseptic (see). The radial cut without damaging the nipple and areola. Opened cavity loosely perform tampons soaked Vishnevsky ointment. Treatment of patients with running mastitis (gangrenous, flegmona and abstemious form) in General condition should be carried out in the hospital. In chronic inflammatory mastitis mandatory biopsy (see) and histological examination.
The question about the possibility of feeding mastitis is decided individually. When starting mastitis feeding should continue, with the developed mastitis interrupted feeding for a considerable time, and sometimes stop feeding the affected breast.
Prophylaxis of mastitis is to maintain a nursing women a regular function of mammary glands, prevent stagnation of milk, observance of rules of personal hygiene, prevention, and treatment of cracks and excoriation in the nipple (see Pregnancy, prenatal care). Mastitis in the newborn - see the Newborn.
Cm. also Mammary gland.


Mastitis (mastitis; from the Greek. mastos - chest; synonym: mastadenitis, grudnia) is an inflammation of the breast, which was observed more frequently in nursing mothers, and mainly in nulliparous, very rarely in men with gynecomastia. Sometimes Teens in puberty there is the so-called youth mastitis.
The etiology and pathogenesis. Agents of mastitis are almost always normal pyogenic bacteria (Staphylococcus, Streptococcus, sometimes E. coli and other). Through the fragile skin of the nipple, cracks, scratches, abrasions, excoriation of the epidermis microbes through the lymphatic vessels penetrate into the interstitial tissue of the breast and lead to the development of the inflammatory process. Less frequently they penetrate dairy passages, causing inflammation (galactophore). Infiltrating breast microbes curdling milk output streams of the lobules. Toxins damage the epithelial lining the ducts and lobules, creating favorable conditions for penetration of microbes in the interstitial tissue, which leads to the formation of abscesses or phlegmon. The process may be restricted by inflammation adjacent to the nipple and subcutaneous education subareolar abscess (Fig. 1, 1). Than virulente infection, the faster it leads to the development of purulent process in the thickness of the breast (intramammary abscess; Fig. 1, 2).
In glandular organs of purulent process usually not distinguished, and applies, involving a large number of glandular tissue.
Some patients in the breast quickly produce large quantities of small ulcers.
When the abscess in segments on the back surface of the breast, it may be opened in fiber space behind her, and then there is a rare form - retromammary abscess (Fig. 1,3).