Breast, Abscess and necrosis [LMP11980]

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Diagnostic Modality: 
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Disease Category: 
Acute and Chronic Inflammation
Diagnosis: 
Breast abscess and necrosis
Species: 
Human
Organ System: 
Breast
Gender: 
Female
Age: 
29 years
Diagnosis Code: 
ICD-10: O91.1
Slide Contributor Information
Hodgson, A., Slodkowska, E.

Keywords

breast, abscess, necrosis, mastitis, bacterial, staphylococcus

Clinical History

4 weeks post-partum.

Clinical Discussion

Mastitis and abscess formation generally develop when flow to one or more of the major ducts is obstructed. This obstruction leads to stasis. Bacteria isolated from the infected nipple discharge are often common skin inhabitants such as Staphylococcus aureus, different streptococci species, and coagulase-negative staphylococcus. To drain the collections, needle aspiration is usually attempted, in combination with antibiotics. If this therapy is unsuccessful, surgical draining may be required (as it was in this case). This case shows necrotic breast tissue with abundant inflammation. Gram stain revealed numerous bacterial cocci. Stains for fungi and TB were negative.

This patient was 4 weeks post-partum, with evident mastitis and multiple collections seen on ultrasound. She had fever as well as pain and tenderness - all signs of infected lactational mastitis and abscess formation.

In the literature, there are many cases reported of breast abscesses being caused by some interesting microorganisms, such as Salmonella typhi, Brucella species, and different mycobacteria.