Mastitis: symptoms and treatment in a nursing mother, photo

Mastitis is an inflammatory process in the mammary gland, which most often develops in a nursing mother. However, it can also be found in women who have not yet given birth.

It is accepted to isolate several varieties of mastitis:

1. 1) Postpartum mastitis
   
2. 2) Newborn mastitis
   
3. 3) Mastitis is carcinomatous, which develops against the background of metastatic lesions of the mammary gland cells of malignant tumors.

Mastitis stages

Acute mastitis is characterized by a successive change of one stage to another, especially in the absence of timely access to medical care. There are three main stages of this pathological process:

• serous
  
• infiltration stage
  
• purulent.

In the first stage, the inflammatory process is just beginning. The focus of inflammation involves leukocytes, which try to limit it. However, if the reactivity of the body is reduced or the microflora is particularly virulent, the mastitis passes to the next stage - the infiltrative one, which can pass into a purulent one.

The purulent stage can proceed in one of two forms:

1. 1) Phlegmonous - there is no delimiting capsule and pus spreads into surrounding tissues
   
2. 2) Gangrenous - tissue necrosis is observed as a result of circulatory disturbance, with the patient's condition extremely difficult.

Causes and risk factors for mastitis

To ensure that a lactating mother develops mastitis, there must be certain risk factors. These include the following:

• blockage of the milk ducts during lactation, when all conditions for the propagation of microorganisms
  
• are created inside them, nipple fractures that occur when breastfeeding is not properly provided
  
• violation of personal hygiene rules in the care of the mammary glands
  
• presence of pustular mammary gland lesions, in which microorganisms can enter the duct system of the chest
  
• diabetes mellitus, characterized by a decrease in the overall reactivity( resistance) of the organism
  
• presence of implants in the mammary gland
  
• concomitant infectious diseases
  
• reception of glucocorticosteroids reducing the immunity
  
• long-term smoking, against which the blood circulation in the mammary gland
  
• is severely disrupted, malignant oncological diseases that can metastasize into the mammary gland.

However, the immediate cause of mastitis is infection of the breast tissue of the microorganism. It can be both conditionally pathogenic microorganisms, and necessarily pathogenic.

The first and normally live on the skin and mucous membranes, but cause the development of the inflammatory process only when the defenses of the body decrease. The latter fall from the outside. The main pathogens of mastitis are currently considered to be the following:

• Staphylococcus
  
• Streptococcus
  
• Pseudomonas aeruginosa
  
• Escherichia coli and others.

Symptoms of mastitis in a nursing mother

In a nursing mother, clinical manifestations of mastitis depend on the stage of the pathological process. The more neglected, the harder the disease.

In the serous stage, symptoms of mastitis appear such as:

• body temperature increase
  
• weakness
  
• increase in the size of the affected breast
  
• it becomes dense( swollen) and hyperemic( reddened)
  
• when palpation is determined the soreness of the mammary gland
  
• does not facilitate feeding or expressing the mammary glandsthe patient feels well, and even strengthens the pain syndrome
  
• , the initial changes in the general clinical analysis of the blood are determined - the increase in leukocytes and the acceleration of the ESR.

If the process passes into the infiltrative stage, then the condition of the woman is aggravated. The following symptoms are added to the above mentioned symptoms:

• when mammary gland is palpated, a clear infiltrate is determined which is delimited from the surrounding tissues.
  
• the skin becomes even redder in the
  
• lesion zone, a fluctuation appears, that is, the softening point in the mammary gland that is associated with the appearance of purulent inflammation.
  
• temperature rises tohigh values ​​of
  
• the pulse of
  
• becomes more frequent, blood pressure, etc. can decrease.

When a purulent cavity appears, sleep is severely disturbed. The first sleepless night associated with a purulent mastitis is an indication for an autopsy. However, with timely access to medical care, this can be avoided.

Diagnosis

Diagnostic search for suspected mastitis includes the following studies:

1. 1) A general clinical blood test in which the elevated white blood count is determined, the sedimentation rate of the red blood cells
   
2. is accelerated 2) Bacteriological examination of the discharge from the nipple, as well as the discharge from the wound with the determinationsensitivity to antibiotics of isolated microorganisms
   
3. 3) Ultrasound examination of mammary glands
   
4. 4) Radiographic examination of mammary glands( ma(the latter can be excluded only after a histological examination)
   
5. 5) To exclude specific infections, it is necessary to conduct a study for tuberculosis, actinomycosis, etc.

In some cases, it is necessary to carry out a differential diagnosis of carcinomatous mastitisdiagnosis of mastitis with other diseases that have similar clinical manifestations. This can be pathological processes such as:

• infected breast cysts
  
• breast cancer that proceeds as mastitis
  
• tuberculosis( tuberculoma)
  
• syphilis( syphilitic gum)
  
• actinomycosis - infection of actinomycetes with breast tissue.

Treatment of mastitis

Treatment of mastitis in a nursing mother can be both conservative and operative, which depends on its stage. In the case of spruce, there is an abscess, then a surgical dissection is indicated, since the pus must have an outlet outward. This will significantly alleviate the condition of the patient and will facilitate the speedy recovery of the woman.

Conservative treatment is effective only in the serous and infiltrative stage. It includes the following directions:

1. 1) Antibacterial therapy
   
2. 2) Regular expression of mammary glands to prevent lactostasis( lactation is prohibited during this period)
   
3. 3) Lactation suppression is indicated by medication
   
4. 4) Non-steroidal anti-inflammatory drugs thatadditionally reduce the severity of pain
   
5. 5) Local resorption therapy for the affected mammary gland, for example, compresses with dimexid.

Surgical treatment of purulent mastitis is a wide opening of the purulent focus with subsequent drainage. In the following, the purulent cavity is washed with antiseptics.

In parallel, the use of anesthetics and antibacterial drugs is indicated. After treatment of a purulent cavity the doctor necessarily imposes an aseptic bandage.

Prevention measures for mastitis

All preventive measures that are currently designed to prevent the development of mastitis are related to lactational damage to the breast. For this, it is recommended that you follow the following rules:

• adherence to personal hygiene rules for breast care
  
• Breastfeeding after breastfeeding if the latter remains dense
  
• Regular feeding the baby alternately with one or the other breast
  
• using creams that soften the skin of the nipple and nipple, preventing the appearance of cracks.

In conclusion, it should be noted that mastitis usually develops against a background of predisposing factors that create conditions for infection of breast tissue by microorganisms.

Late application of women for medical care and, as a consequence, late diagnosis and treatment lead to the transition of one stage of the infectious-inflammatory process to another.

This has a very negative effect on the general condition of patients. Therefore, the earlier treatment is initiated, the more effective and faster it leads to clinical improvement.

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