Medical history (history of illness) is an important component in the diagnosis of mastitis (inflammation of the mammary glands). Family history Social anamnesis Current anamnesis/systemic anamnesis (somatic and psychological complaints). How long has the chest pain been present? Has there been any change in the pain? Become stronger?* Did the pain come on suddenly? Where … Mammary Gland Inflammation (Mastitis): Medical History
Mastitis puerperalis (mastitis in the puerperium) Skin and subcutaneous (L00-L99). Allergies (personal care, cosmetics, jewelry). Atopic eczema (neurodermatitis) Dermatoses (including psoriasis, herpes zoster, herpes simplex, urticaria, acne, borrelia). Lupus erythematosus cutaneus Scleroderma Infectious and parasitic diseases (A00-B99). Erysipelas – nonpurulent infection of the skin and subcutaneous tissue caused predominantly by group A ß-hemolytic streptococci (GAS … Mammary Gland Inflammation (Mastitis): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by mastitis (inflammation of the mammary glands): Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). Mammary abscess (abscess of the mammary gland; formation of a pus cavity). Recurrence of mastitis (inflammation of the mammary gland).
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height. Gynecological examination Inspection of the mammae (breasts), right and left; the nipple (nipple), right and left, and the skin [rubor (redness) of the breast?; tumor (swelling) of the breast?; … Mammary Gland Inflammation (Mastitis): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) [mastitis puerperalis: +; mastitis non-puerperalis: ++; mammary abscess: ++] Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic … Mammary Gland Inflammation (Mastitis): Test and Diagnosis
Therapy goals Elimination of the pathogens or the complaints. Avoidance of complications Therapy recommendations Mastitis puerperalis (inflammation of the mammary glands during the puerperium) Emptying (“drinking empty”) the breast or expressing the milk and, in the early stages, cooling the breast (cooling compresses) Note: Weaning is not required on a regular basis! (Prolactin inhibitor is … Mammary Gland Inflammation (Mastitis): Drug Therapy
The diagnosis of mastitis is usually made on the basis of history and physical examination. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Mammary ultrasonography (ultrasound examination of the breast; breast ultrasound) – for suspected mastitis puerperalis … Mammary Gland Inflammation (Mastitis): Diagnostic Tests
1st order Incision (cutting) and counterincision with insertion of a flap – performed when an abscess has formed. Also mammary sonography-guided abscess puncture if necessary; contraindications: Suspected inflammatory breast carcinoma/breast cancer; strongly accepted abscesses (relative contraindications). Advantages of breast ultrasonography (breast ultrasound) guided abscess puncture: Can be performed on an outpatient basis, so breastfeeding can … Mammary Gland Inflammation (Mastitis): Surgical Therapy
To prevent mastitis, attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Tobacco (smoking) (mastitis non-puerperalis). Insufficient hygiene during breastfeeding (mastitis puerperalis). Relapse prophylaxis in mastitis puerperalis (mastitis in the puerperium) Breastfeeding hygiene Nipple care Different breastfeeding positions Adapted breastfeeding technique with the aim of emptying both breasts. Relapse … Mammary Gland Inflammation (Mastitis): Prevention
The following symptoms and complaints may indicate mastitis (inflammation of the mammary glands): Leading symptoms Rubor (redness) of the breast Calor (overheating) of the breast Tumor (swelling) of the breast Dolor (painfulness) of the breast Functio laesa (here: limited breastfeeding function). As a rule, pain and usually unilateral local redness and swelling of the breast … Mammary Gland Inflammation (Mastitis): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Mastitis puerperalis (puerperal mastitis) is caused by an intracanalicular ascending (ascending) infection, usually originating from nipple rhagades. Bacteriological infection of the mammary gland tissue occurs due to: Staphylococcus aureus (95%). Staphylococcus epidermidis (4%) Streptococcus (3%) Pseudomonas aeruginosa (< 1 %) Et al. Mastitis non-puerperalis has a pathogenesis that is not yet … Mammary Gland Inflammation (Mastitis): Causes
General measures In the early stages, cooling and immobilization of the breast, for example, with cold compresses and a tight bra are useful. The milk should be pumped to prevent further milk stasis. Observance of the general hygiene measures! Nicotine restriction (refrain from tobacco use). Alcohol restriction (abstaining from alcohol) Review of permanent medication due … Mammary Gland Inflammation (Mastitis): Therapy
