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Abscess of the breast
A limited area of accumulation of pus in the layers of the tissues of the breast is called the abscess of the breast.
This disease is not so common. It, as a rule, is secondary, and appears as a result of other inflammatory processes in the gland, for example, mastitis. Nevertheless, despite the low incidence rate, it is necessary for a woman to know about this disease, which is not indifferent to her own health.
Causes of the abscess of the breast
The abscess of the breast begins, as a rule, after the penetration of the microbial infection through the nipple. Most often it can be observed with nipple and nasal congestion in the first time after lactation. Sometimes the onset of the disease is caused by the inability of the nipple to constantly irritate, or stagnant milk in the breast (when the child does not suck it enough, or the mother for some reason does not want or can not breast-feed). If the nipples have cracks and irritations, then the infection can be simply recorded if the hygiene rules are not observed - with dirty hands.
Among other possible causes of breast abscess, the following can be named:
- obstruction of the milk ducts can provoke the appearance of cysts and infection, in this case, an abscess;
- mastitis and other inflammatory diseases of the breast can lead to the spread of infection in the subcutaneous tissue of the gland.
The causative agent of the disease most often become staphylococci and streptococci, or a combination of staphylococcal infection with gram-negative bacteria - a protea or E. Coli.
Symptoms of the abscess of the breast
Symptoms of breast abscess most often begin with fever, fever. The affected gland becomes extremely painful, so much so that it can not be used for feeding. The lobes of the gland nearest to the foci of infection are thickened and enlarged.
Little by little, the inflammatory process also spreads to other areas of the breast. Skin over them blush, swell, until a visible abscess is formed - an abscess.
The disease can occur in several pathological forms:
- superficial form of abscess (subareolar), when the process is formed in the sucking in the subcutaneous tissue;
- intramammary form of abscess, when the disease occurs against the background of stagnant mastitis. With this pathology, isolated areas of necrosis can be formed, and in severe cases, the abscess breaks and purulent contents leak out;
- a retromammary form of an abscess, when the abscess forms on the posterior part of the gland. In such a situation, pus can also go out, breaking through the fiber between the organ and the external thoracic fascia.
Virtually all stages of the inflammatory process occur against a background of high fever: fever may drop slightly after an abscess breakthrough.
Diagnostics of the abscess of the breast
Diagnosis of breast abscess, as a rule, does not cause problems. The characteristic symptomatology of the disease usually allows you to establish a correct diagnosis and prescribe the right treatment. Only in some cases, with long-term, chronic abscesses, it is possible to conduct a distinctive diagnosis of an abscess from a malignant or benign tumor.
Most often, the diagnosis is established on the basis of characteristic symptoms, laboratory-instrumental examinations, diagnostic manipulation (abscess biopsy).
A blood test usually indicates the presence of a persistent inflammatory process: an increase in the level of leukocytes, accelerated ESR.
Urinalysis can be indicated by proteinuria and leukocyturia.
With bacteriological seeding of the discharge from the nipple, a pathogenic microflora can be detected.
When probing the affected gland, a round convex formation, fluctuating due to the fluid content of the abscess, is determined. The affected gland is enlarged in volume, tense and sharply painful.
Ultrasound of the breast can detect a hypoechoic focus of a rounded configuration on the background of a swollen gland. Due to ultrasound, the location, the size of the abscess can be accurately determined, and a control puncture of the abscess can be made and the contents taken to determine the pathogen.
Treatment of the abscess of the breast
Treatment of acute mammary abscess is an urgent operative. Timely, immediate opening of the abscess, its cleaning and installation of drainage guarantee the preservation of the full functionality of the body in the future.
In addition, the treatment of pathology, which caused the appearance of an abscess (mastitis, cysts, cracks, etc.), is prescribed, and measures are taken to prevent the re-development of the abscess. Therapy with antibiotics (cephalosporins - cefazolin, cephalexin, fluoroquinolones - ofloxacin, moxifloxacin, aminoglycosides - kanamycin, tobramycin, amikacin, isepamycin), intravenous injections of detoxification solutions, immunostimulant therapy. To eliminate the pain syndrome prescribe analgesics (over-the-counter: paracetamol, analgin).
If the breast abscess formed during breastfeeding, then breastfeeding is stopped throughout the course of treatment and recovery.
After elimination of the acute process, physiotherapy, massage therapy are prescribed.
Prevention
In order to prevent breast abscesses, you should carefully follow the rules of personal hygiene:
- Wash hands under running warm water using soap, immediately before each feeding or procedure of decantation;
- every day, wash the glands with warm water and detergent (avoiding the area of the nipples) and change the bra to clean;
- every day for a short period of time should leave the breast open;
- when cracks appear, you can use sea buckthorn or peach oil, a solution of vitamin A, Bepanten ointments or Purelan;
- when using breast pads, you need to change them in time;
- the child must be fed until he releases the breast himself, or wean carefully, helping the little finger, opening his mouth and freeing the breast;
- do not allow milk stagnation, regularly express milk;
- avoid hypothermia and chest injuries;
- timely treatment of mastitis and other inflammatory processes in the gland, strengthen immunity, eat right.
Forecast
Timely treatment and treatment of the disease guarantees a favorable prognosis for life and preservation of the gland function. Restriction of work capacity is observed only in the period of illness.
Incorrect and late-started treatment carries the danger of involuntary removal of the affected organ, since in neglected cases, scarring of the gland, suppurative melting of tissues and formation of fistulas with purulent and milky discharge can be observed.
To avoid complications and start treatment on time, you should consult a doctor if you feel pain in the gland, find redness, tightness, if you have a fever, there are symptoms of intoxication: headache, muscle pain, nausea and vomiting.
The abscess of the breast is not so terrible, if the measures for its elimination are taken on time.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"