A 14 week post natal woman presents with fluctuant breast swelling, what would be the treatment
Ans. (d) Repeated aspiration under antibiotic cover(Ref Bailey and Love 27th edition Page 866)* The clinical diagnosis of a lactating mother at 14 weeks is usually a mastitis followed by Breast abscess. Abscess presents with Fluctuant swelling* During cellulitis stage - only Antibiotic such as Flu cloxacillin and Co amoxiclav can be used. Feeding can be given via the affected stage at this time. Analgesics will help to relieve pain with support of breast.* In antibiotics alone used in the presence of underlying pus - Antibioma will form.* Olden days - Incision and Drainage was advised if not resolves in 48 hours.* Latest recommendation: Repeated aspirations under antibiotic cover (if needed under USG Guidance) to be performed. This allows resolution without Incision and Drainage and will also allow breast feeding in the affected breast.
Incision and Drainage
Continue Breast feeding with antibiotics
Analgesics
Repeated Aspirations under antibiotic cover.
Breast