Physiological mastitis in newborns: symptoms and treatment. Mastitis - its code, according to the international statistical classification of diseases Breast infiltrate code for microbial 10

Non-lactational mastitis is an inflammatory process in the mammary gland caused by bacterial infection, chemical or mechanical injury. Pathology is not associated with breastfeeding and occurs in patients against the background of hormonal disruptions or other infectious diseases. At risk are women from 15 to 45-50 years old. In ICD-10, this form of mastitis is in section N60-N64 "Diseases of the mammary gland not associated with childbearing." Pathology was assigned the number N61.

Main reasons

Non-lactational mastitis is caused by microbes and bacteria that enter the milk ducts and spread to the connective tissues. In most patients, one quadrant of the breast becomes inflamed, less often several at once.

Acute and in 69-85% of cases causes Staphylococcus aureus. Chronic - gram-negative microorganisms resistant to classical antibiotic therapy.

The infection enters the mammary glands in two ways: from the outside and from the inside. Common external causes include:

• mechanical injuries of the chest;
• cracks in the nipples;
• plastic surgery for breast augmentation with gel or silicone implants;
• frequent discharge from the nipples caused by hormonal disorders;
• hypothermia.

The causative agent of mastitis can also enter the milk ducts from oral cavity a sexual partner with a sore throat, chronic tonsillitis or caries. Infection occurs during foreplay or sexual intercourse.

Bacteria also enter the mammary glands through lymphatic system. Women with non-lactational mastitis are often diagnosed with acute or latent inflammatory diseases of other internal organs. The most common reasons include:

• pyelonephritis;
• chronic tonsillitis;
• inflammation of the uterus or appendages;
• tuberculosis;
• HIV and AIDS;
• blood diseases;
• advanced caries.

Non-lactational forms of mastitis are also associated with hormonal disorders in female body. The disease occurs against the background of an increase or decrease in estrogen and prolactin, as well as against the background of fibrocystic formations in the chest.

There are three most dangerous periods:

1. Teenager, 14–18 years old. The ovaries synthesize a lot of estrogen, and immunity is reduced due to the active restructuring of the body. Hormonal changes and problems with the immune system create conditions for the development of inflammation.
2. Reproductive, 19–35 years old. There is a high probability of dyshormonal hyperplasia and fibrocystic formations in the chest. Mastitis occurs due to the active growth connective tissue and glandular hypertrophy.
3. Premenopausal, 45–55 years. The concentration of estrogens and immunity decreases, sensitivity to microbes and bacteria increases.

Types of non-lactational mastitis

Non-lactational mastitis is divided into two types: acute and chronic. In the acute course of the disease, inflammation quickly spreads to soft tissues. Fluid accumulates inside the mammary gland, and then a capsule is formed filled with purulent contents, or even several. The cyst increases in size and, if not adequately treated, can turn into an abscess.

At chronic form a small, painless seal is felt in the chest. It practically does not cause discomfort, so some patients are advised to simply observe the neoplasm and do nothing. Others are prescribed surgical treatment and hormone therapy to prevent relapses.

Disease danger

Non-lactational purulent mastitis can cause abscess and necrosis of breast tissues. The neglected form of the disease causes sepsis - blood poisoning, which leads to severe intoxication of the body and death.

The acute form is lactational mastitis with improper treatment, it becomes chronic. Patients with chronic breast disease often relapse and develop purulent fistulas that require surgical treatment.

Chronic mastitis also creates conditions for the development of breast cancer. The symptoms of the diseases are similar, so women with suspicious signs should not refuse a comprehensive examination and self-medicate.

Symptoms

Different forms of mastitis have different symptoms. The acute variant begins suddenly. First, a small seal occurs in the nipple area. It is accompanied by swelling of the mammary gland, redness of the skin and an increase in temperature to 37-38 degrees. Mild appears in the chest nagging pain. This is the first or serous stage of non-lactational mastitis.

When the serous stage becomes infiltrative, the temperature rises to 38–39 degrees and additional symptoms appear:

• hard single or multiple seals that hurt when pressed;
• severe swelling and breast enlargement;
• headaches, weakness, dizziness and other signs of intoxication;
• severe drawing pains.

The infiltrative stage can turn into a purulent one. The patient's signs of intoxication will increase, the lymph nodes in the armpits will become inflamed. The formations inside the mammary gland will become softer and more elastic, filled with pus. The pain in the chest will increase and spread to the lymph nodes. In some patients, pain radiates to the area under the scapula and limits the mobility of the upper limbs.

Symptoms of chronic mastitis are not so pronounced. The ultrasound machine shows the presence of an infiltrate or abscess, but the compaction is usually not painful on palpation and is not accompanied by intoxication of the body. In severe cases, women may develop fistulas with a meager secretion.

Chronic non-lactational mastitis is also characterized by:

• increased concentration of leukocytes and ESR in the blood;
• symptomatic hypotension;
• heart palpitations;
• discharge of pus from the affected nipple;
• deformation of the mammary glands.

With chronic non-lactational mastitis due to polyacrylamide gel breast augmentation, fistulas can spread to the chest and abdominal walls and cause massive suppuration.

Diagnostics

At the first symptoms of inflammation, the mammary gland should be shown to a gynecologist or surgeon. The doctor can make a preliminary diagnosis after a visual examination and palpation of the chest.

Additional examinations will help confirm the diagnosis and determine the cause of non-lactational mastitis:

• breast ultrasound to rule out cancer;
• general blood analysis;
• general urine analysis;
• sowing pus from the nipple or fistula on nutrient media;
• biopsy.

If the ultrasound does not give accurate results, the doctor refers the woman to a mammogram. The procedure will help distinguish non-lactating mastitis from abnormalities of the milk ducts and lobules, as well as from breast cancer.

Patients with abscess and phlegmonous form are recommended to puncture the formation and bacteriological examination its contents. Also, a woman should go comprehensive examination to determine which disease caused hormonal failure or decreased immunity and the development of mastitis.

Treatment

Non-lactational mastitis in serous and infiltrative form is treated conservatively. With abscessing, infiltrative-purulent and phlegmonous stages, surgical intervention.

Conservative treatment

At the initial stage of the disease, women are recommended to apply an ice pack to the area of ​​​​inflammation. Local hypothermia slows down the development of infection, reduces swelling, pain and redness of the skin. Cold compresses are wrapped in a cloth or towel to prevent frostbite.

It is useful for patients to wear special underwear that lifts the mammary glands and protects against severe swelling and a feeling of heaviness. Cold compresses and supportive bras are supplemented with non-steroidal anti-inflammatory drugs:

• Butadione;
• ibuprofen;
• Aspirin.

Swelling and heaviness in the mammary gland are removed antihistamines. The most effective are:

• Tavegil;
• Diphenhydramine;
• Pipolfen;
• Suprastin.

With a decrease in immunity and to speed up recovery, drugs are supplemented with multivitamin complexes, in which vitamins A and E are present.

Antibacterial drugs are prescribed if the patient complains of severe chest pain, elevated temperature or fever, or when mastitis extends beyond one quadrant of the breast and spreads to healthy tissue.

The infiltrative and serous form of the disease is treated with antibiotics. penicillin series:

• Flucloxacillin;
• Oxacillin;
• Ampicillin;
• Dicloxacillin;
• clavulanate;
• Amoxicillin.

Antibiotics of the penicillin series can be replaced by cephalosporins. This group of drugs includes:

• Cefadroxil;
• Cefuroxime;
• Cephalexin;
• Cefaclor.

Resistant forms of bacteria and microbes are treated with third and fourth generation antibiotics: aminoglycosides and fluoroquinolones. Aminoglycosides include "Stretomycin" and "Neomycin". The group of fluoroquinolones includes:

• Ofloxacin;
• Pefloxacin;
• Norfloxacin;
• Sparfloxacin;
• Ciprofloxacin.

Antibiotics are taken orally. With colostrum-like discharge from the nipples, patients may additionally be prescribed Parlodel or similar preparations. Means from this group suppress lactation and improve hormonal levels.

Surgery

Non-lactational purulent mastitis can only be treated surgically. In the abscessing and infiltrative-purulent stages, the formation is opened and the contents are aspirated. Manipulation is carried out through a small incision 0.5-1 cm long. It is done over the place of the greatest accumulation of pus.

The infiltrate cavity is washed with antiseptic solutions or antibiotics. A rubber drainage is introduced inside, which is left for several days. With the help of drainage, pus is removed from the infiltrate and the wound is washed.

With the phlegmous and gangrenous stages of mastitis, the doctor can remove not only the formation, but also the tissues that surround it. Before surgery, patients are prescribed anti-inflammatory treatment, which reduces the lesion and helps to determine the clear boundaries of the infiltrate.

During the rehabilitation period, women are advised to undergo drug therapy to prevent complications and relapses. After the operation, the doctor prescribes intravenous injections antibiotics and solutions of sodium chloride, glucose and polyglucin to detoxify the body. Antibacterial drugs are supplemented with antihistamine, multivitamin complexes and anti-inflammatory drugs.

Prevention

Prevention of non-lactational mastitis consists in observing the rules of hygiene and timely contacting a doctor at the first symptoms of the disease. Experts do not advise self-treatment and wait until the infiltrative stage turns into an abscess.

Patients with hormonal disruptions and fibrocystic mastopathy it is necessary to regularly visit a gynecologist or mammologist and monitor the condition of the mammary glands. Women with chronic and acute inflammatory diseases of the internal organs should not refuse treatment, because the presence of an infection in the body leads to a decrease in immunity and creates conditions for the development of mastitis.

Some forms of non-lactational mastitis are self-limiting and do not require specific treatment, observations only. Other forms of the disease may develop into serious pathologies with numerous complications, therefore, for any signs of inflammation in the mammary glands, you must consult a doctor and follow all the instructions of a specialized specialist.

The mammary glands are a "mirror", which indirectly reflects the entire state of the woman's body. The morphology of this organ is a close object of attention of doctors, because in many diseases it is in the chest that the first changes appear.

This is a group of pathologies that are different in terms of reasons and mechanism of development, encrypted by doctors with special numbers.

What do they mean, and how not to get lost in medical encryption in order to have full information about your health?

ICD 10 diagnosis statistics

ICD 10 (No. 60-64) diseases of the mammary glands are subject to careful statistical analysis. This is one of the reasons why the unified classification was introduced. According to the latest data from the World Health Organization, up to 40% of women suffer from mastopathy among the female population of the world, and more than half of all cases (up to 58%) are combined with gynecological disorders. Of particular interest is the fact that many breast diseases are also precancerous conditions. The incidence and mortality rate from breast cancer is increasing every year, even despite the huge advances in medicine in the field of their early diagnosis and effective treatment. The lion's share of cases occurs in developed countries.

The internationally accepted classification of ICD No. 10 is also used in our country. Based on it, there are:

· N 60 - Benign growths of the mammary gland. Mastopathy belongs to this group.

· N 61 - Inflammatory processes. Among them are carbuncle, mastitis, abscess.

· N 62 - Enlargement of the mammary gland.

N 63 - Volumetric processes in the chest, unspecified (knots and nodules).

· N 64 - Other pathologies.

Each of these diseases has its own causes, characteristic clinical picture, methods of diagnosis and treatment. Let's talk about this now.

The definition of the disease was back in 1984 by the experts of the World Health Organization. It characterizes benign dysplasia as a combination pathological mechanisms, manifested by both regressive and progressive changes in the tissues of the mammary glands with the appearance of abnormal relationships between the epithelium and the connective tissue.

Also, according to the definition, an important sign is the formation of changes in the breast such as fibrosis, cysts and proliferations. But this is not the primary symptom for making a diagnosis, because. it is not always available.

Clinical picture of the diagnosis

The disease may appear various signs. But the main symptoms can be distinguished:

· Dull pain in the mammary glands, which often tends to increase before the onset of menstruation. After passing menstrual bleeding the pain usually subsides.

Irradiation - the spread of pain outside mammary gland. Often patients complain that pain is given to the shoulder, shoulder blade or arm.

The presence of education in the breast or compaction of its structure. This symptom can be determined by patients who are attentive to their state of health and regularly palpate.

Diagnostics

The doctor begins the examination with a thorough collection of anamnestic data. The doctor clarifies the patient's onset of menstruation, its nature, cyclicity, soreness, profusion. The gynecological history is also important, which consists in the age of onset of sexual activity, the number of pregnancies, miscarriages, abortions, childbirth. Genealogical data will help to understand whether there were similar diseases in blood relatives female line. All this information helps to establish the correct preliminary diagnosis.

An objective examination will help the doctor to identify the asymmetry of the mammary glands, and when they are palpated, to determine the presence or absence of neoplasms. Special attention mammologists pay attention not only to the consistency and structure of the mammary gland, but also to the color, size and condition of the nipples.

Instrumental methods confirm the correctness of the alleged diagnosis or, conversely, refute it and return the doctor to the beginning diagnostic search. Most often resort to mammography and ultrasound of the mammary glands. Additionally, the patient's blood and urine are studied.

Therapy

Treatment of diseases of the mammary glands No. 60 ICD10 is possible in 2 versions. The first is medication, which is used for diffuse growths. A good result can be achieved by hormonal agents, including oral contraceptives.

The second method is surgical, which is indicated for the nodular form. The remote formation is subject to mandatory histological examination to exclude the presence of atypical cancer cells. The prognosis after treatment is favorable.

ICD-10 No. 61 breast diseases included: abscess, carbuncle and mastitis, which is considered the most common pathology in this group.

Mastitis is an inflammatory disease. The defeat of the breast is often unilateral, and only in rare cases (not more than 10%) extends to both mammary glands. The cause of the disease is two main factors that overlap one another:

The first is a violation of the outflow of milk;

The second is the addition of pathogenic or conditionally pathogenic microflora.

Initially, the disease proceeds according to the type of aseptic (sterile) inflammation. However, very quickly, literally in a day, in conditions of stagnation of milk secretion and a favorable temperature, the microflora is activated. Thus begins the stage of bacterial inflammation.

Main symptoms

The clinical picture is almost the same in all women. The first symptom is a sharp rise in temperature to high values ​​​​(38 - 39 ° C). Further, redness of the skin of one of the mammary glands joins, and then severe pain. As time goes by, they only get stronger. With severe inflammation and the absence of timely treatment, sepsis develops very quickly - a deadly complication.

Diagnostics

The diagnosis is established on the basis of anamnestic, objective and laboratory data. From the anamnesis it turns out that the woman is breastfeeding. As a rule, the risks increase if you constantly apply the child in the same position. In this case, incomplete emptying of the gland occurs. An objective examination shows hyperemia of the inflamed gland, its slight increase, as well as sharp pain on palpation. At laboratory research in the blood, leukocytosis with high values ​​is detected.

Treatment

In the early stages, conservative (drug) treatment is also effective. The main condition is the thorough expression of milk. For these purposes, a breast pump is not the best solution; it is best to do it by hand. The patient can perform the procedure on her own, but often, due to severe pain, it is necessary to turn to specially trained people. Of the drugs resort to antibiotics a wide range actions. Usually these measures are enough for a complete recovery and further restoration of breastfeeding.

At severe forms illness before appointment operational method Treatments attempt to temporarily stop lactation with the help of special medicines. If this method was ineffective, then surgeons take up the treatment.

Other inflammatory diseases of the breast

Carbuncles and abscesses of the mammary gland also occur in clinical practice, but are now becoming less and less common. Carbuncle of the mammary gland, as in any other part of the skin, is a purulent inflammation hair follicle and sebaceous gland. An abscess is a purulent fusion of the mammary gland limited from healthy tissues.

The cause of the disease in carbuncle is a blockage of the sebaceous gland, against which pathogenic microflora. An abscess can develop as a result of hematogenous or lymphogenous infection from other foci.

Both diseases occur with an increase in temperature, an increase in soreness in one of the mammary glands.

Treatment is often performed surgically. The abscess is opened, freed from purulent contents, treated with an antiseptic solution, and then drainage is established for a while. The patient is prescribed a course of broad-spectrum antibiotics. With timely treatment, the prognosis is always favorable.

In this group, it is customary to single out gynecomastia, which occurs only in men. It is characterized by the growth of breast tissue and, accordingly, its increase. In women, this process is called breast hypertrophy, and also belongs to this group.

The risk of hypertrophy increases the consumption of beer, because. This drink contains plant estrogens. They also stimulate active cell division.

It is worth noting that such a diagnosis is established not only in women, but also in men, but their ratio to each other is 1:18. Mostly women aged 20 to 85 are ill, but it is more common in 40-45 years. Mortality from the disease is 0%.

Causes

The etiology of the disease is not fully understood.

Clinical picture

The first time the disease has no symptoms at all, this is the so-called latent phase of the disease. The duration of this period is individual and can vary from several months to a year or more. The first symptom is periodic pain in the breast, which may increase before the onset of menstruation. Pain, as a rule, subsides immediately after the end of menstruation.

The biggest mistake patients make is not paying attention to changes in own body and do not go to doctors, attributing ailments to hormonal imbalances, the beginning of a new cycle, or proximity menopause. Over time, the pain takes on a constant aching character. With careful self-palpation, the patient can detect a formation in the chest, which often serves as a reason to see a doctor.

Diagnostics

Main research methods:

Collection of complaints

assessment of anamnestic data;

laboratory research methods (general clinical analysis blood, urinalysis, biochemical analysis blood test or study for tumor markers);

instrumental methods (ultrasound, mammography, biopsy).

Treatment

All breast neoplasms are subject to surgical treatment. After removal, the biological material in 100% of cases is sent to histological examination thus establishing an accurate diagnosis and the need for further treatment.

Other diseases of the breast (N64) ICD10

This group includes:

galactocele - a cyst in the thickness of the mammary gland, filled with milk;

involutive change after breastfeeding;

secretion from the nipple outside the lactation period;

Inverted nipple

Mastodynia is a condition that is perceived subjectively. It is characterized discomfort in the chest. They may be present continuously or intermittently.

Prevention of breast diseases

A priority place in the working tactics among gynecologists and oncologists is propaganda for the prevention of breast diseases. This should include social advertising, various medical brochures, preventive conversations with patients at the reception, increasing popularity healthy lifestyle life, as well as affirmation world day to fight breast cancer.

To minimize the risk of developing the disease, as well as not to miss it at an early stage, one should adhere to the following rules:

Refusal to smoke and drink alcohol;

treatment of acute diseases, as well as prolongation of the remission phase in chronic;

passing preventive examinations, especially over the age of 35 years;

Performing self-palpation of the mammary glands at home at least once every 4-6 months.

Benign breast dysplasia according to ICD-10 or mastopathy

Benign breast dysplasia according to ICD-10 or mastopathy is a disease of the mammary glands ( benign tumor). It appears as a result of tissue proliferation with various hormonal disorders and there are 2 types: nodal (single seal) anddiffuse mastopathy(with multiple nodes).Mastopathy occurs mainly in women of reproductive age. This phenomenon is easy to explain. Every month in young body there are periodic changes under the influence of the hormones estrogen and progesterone, which affect not only menstrual cycle, but also breast tissue (stimulation and inhibition of cell division, respectively). Hormonal imbalance, causing an excess of estrogen, leads to tissue proliferation, i.e. to mastitis.Also, the untimely production of prolactin, the hormone of lactation, can lead to the disease (it normally appears during pregnancy and lactation).The development of mastopathy can provoke vitamin deficiency, trauma, abortion, hereditary predisposition, chronic diseases etc. You can feel the appearance of mastopathy on your own. It causes pain in the mammary gland, accompanied by breast enlargement, swelling and induration. Sometimes there may be discharge from the nipples. If you find such signs, you should immediately contact a specialist.

ICD-10, (No. 60-No. 64) diseases of the mammary glands according to the International Classification of Diseases

Medical mastopathy is treated with hormonal (gestagens, estrogen inhibitors, antiestrogen, androgens, used according to the International Classification of Diseases, ICD-10) and non-hormonal drugs Mabustin.Surgical intervention is used for nodular mastopathy and two types are diagnosed: sectoral resection (in this case, the tumor is removed along with the breast area) and enucleation (only the tumor is removed). Surgery is indicated if breast cancer is suspected, the tumor or single cyst rapidly increases.Lifestyle affects the speedy recovery. During the treatment period, it is better to limit the consumption of tea and coffee, include more vegetables and fruits containing vitamins in the diet, refuse bad habits, thermal procedures (for example, in a bath or sauna), wear comfortable underwear. Diagnostics(mammologist) consists of several stages:palpation of the mammary glands in the supine and standing position, examination of the nipples, palpation lymph nodes and thyroid gland;

Mammography - x-ray of the mammary glands;
. Ultrasound to accurately determine the structure and location of the neoplasm in the breast;
. biopsy - examination of tissue for oncogenes;
. hormonal studies, examination of the liver and consultation of specialists (gynecologist, oncologist).

Choice medical tactics depends on the stage of development of the disease and involves the solution of the following tasks: the preservation or termination of lactation, the fight against the causative agent of the disease, the sanitation of purulent foci (if they form). Patients with postpartum inflammation of the mammary glands are advised to temporarily stop breastfeeding. Milk secretion is suppressed only in a small number of patients with certain indications: rapid progression of inflammation with a transition to an infiltrative phase within 1-3 days with adequate therapy, recurrence of purulent mastitis after surgery, phlegmonous and gangrenous forms, postoperative resistance to antibiotics, decompensation from the side other organs and systems.
Before the transition of inflammation to purulent form the basis of treatment is antibacterial drugs, selected taking into account the sensitivity infectious agent. In addition to etiotropic therapy, pathogenetic and symptomatic agents are used that contribute to a faster recovery and prevent complications. Usually in the treatment of the lactational form of mastitis, the following are used:
Antibiotics. A course of antibiotic therapy is prescribed immediately after the diagnosis is made and corrected according to the results of bacteriological examination data. Synthetic penicillins, cephalosporins, aminoglycosides, combined preparations, nitroimidazole derivatives are used.
Antifungal agents. Modern broad-spectrum antibacterial drugs along with pathogens destroy natural microflora. Therefore, antifungal drugs are indicated for the prevention of superinfection, dysbacteriosis and candidiasis.
Means to improve immunity. Immunomodulators, immunocorrectors, vitamin-mineral complexes are used to stimulate nonspecific protection. To increase specific reactivity, staphylococcal toxoid, anti-staphylococcal plasma and gamma globulin are used.
Antihistamines. Taking several antibiotics against the background of altered tissue reactivity often provokes allergic reactions, for the prevention of which drugs with an antihistamine effect are prescribed, and in more severe cases - glucocorticoids.
infusion therapy. Starting with the infiltrative form of mastitis, the introduction of synthetic colloidal solutions, formulations based on dextrans, and protein preparations is indicated. Medicines of these groups allow correcting metabolic disorders, maintaining the functions of the main body systems.
Identification of purulent inflammation is a direct indication for surgical sanitation of the pathological focus. Taking into account the form of the inflammatory process, mastitis is opened and drained or an abscess is punctured, followed by drainage. Properly performed surgical intervention allows you to stop the spread of the inflammatory process, preserve the breast parenchyma as much as possible, and ensure an optimal cosmetic result. After the operation, the patient is prescribed complex drug therapy.
The scheme of combined treatment of mastitis arising in lactation period, provides for the active use of physiotherapy methods. Patients with serous inflammation are shown ultrasound, ultraviolet radiation, oil-ointment dressings with camphor or vaseline oil, balsamic liniment, butadiene ointment. With the transition of the disease to the infiltrative stage, heat loads increase. After intervention for lactational purulent mastitis, subthermal UHF doses, suberythemic and slightly erythemic UVR doses are recommended.

MASTITIS honey.
Mastitis is an inflammation of the mammary gland. Dominant age
Mastitis of newborns occurs in the first days of life as a result of infection of hyperplastic glandular elements.
Postpartum mastitis - during breastfeeding
Periductal mastitis (plasmocytic) - more often during menopause.
Predominant sex
Mostly women are affected
Juvenile mastitis - in adolescents of both sexes during puberty.

Classification

With the flow
Acute: serous, purulent (phlegmonous, gangrenous, abscessing: subareolar, intramammary, retromammary)
Chronic: purulent, non-purulent
By localization - intracanalicular (galactophoritis), periductal (plasmacytic), infiltrative, spilled.

Etiology

Lactational (see)
carcinomatous
Bacterial (streptococci, staphylococci, pneumococci, gonococci, often combined with other coccal flora, Escherichia coli, Proteus).

Risk factors

Lactation period: violation of the outflow of milk through the milk ducts, cracks in the nipples and areola, improper care of the nipples, violations of personal hygiene
Purulent diseases of the breast skin
Mammary cancer
Diabetes
Rheumatoid arthritis
Silicone/paraffin breast implants
Taking glucocorticoids
Removal of a breast tumor followed by radiotherapy
Long history of smoking.

Pathomorphology

Squamous metaplasia of the epithelium of the ducts of the mammary glands
Intraductal epithelial hyperplasia
Fat necrosis
Expansion of the ducts of the mammary glands.

Clinical picture

Acute serous mastitis (may progress with the development of purulent mastitis)
sudden onset
Fever (up to 39-40 ° C)
severe pain in the mammary gland
The gland is enlarged, tense, the skin over the focus is hyperemic, on palpation - a painful infiltrate with fuzzy boundaries
Lymphangitis, regional lymphadenitis.
Acute purulent phlegmonous mastitis
Severe general condition, fever
The mammary gland is sharply enlarged, painful, pasty, the infiltrate without sharp boundaries occupies almost the entire gland, the skin over the infiltrate is hyperemic, has a bluish tint
Lymphangitis.
Acute purulent abscess mastitis
Fever, chills
Pain in the gland
Mammary gland: reddening of the skin over the lesion, retraction of the nipple and skin of the mammary gland, severe pain on palpation, softening of the infiltrate with the formation of an abscess
Regional lymphadenitis.

Laboratory research

Leukocytosis, increased ESR
A bacteriological study is required to determine the sensitivity of microorganisms to antibiotics.

Special Studies

ultrasound
Mammography (breast cancer cannot be completely ruled out)
Thermal Imaging Research
Biopsy of the breast.

Differential Diagnosis

Carcinoma (inflammatory stage)
Infiltrative breast cancer
Tuberculosis (may be associated with HIV infection)
Actinomycosis
Sarcoid
Syphilis
Hydatid cyst
Sebaceous cyst.

Treatment:

Conservative therapy
Isolation of mother and child from other mothers and newborns
Stopping breastfeeding with the development of purulent mastitis
Bandage that suspends the mammary gland
Dry heat on the affected mammary gland
Expression of milk from the affected gland in order to reduce its engorgement
If pumping is not possible, to suppress lactation, bromocriptine is prescribed at 0.005 g 2 r / day for 4-8 days
Antimicrobial therapy: erythromycin 250-500 mg 4 r / day, cephalexin 500 mg 2 r / day, cefaclor 250 mg 3 r / day, amoxicillin-clavulanate (Augmentin) 250 mg 3 r / day, clindamycin 300 mg 3 r / day (if anaerobic microflora is suspected)
NSAIDs
Retromammary novocaine blockade.

Surgery

Aspiration of contents under ultrasound guidance
Opening and drainage of the abscess with careful separation of all ligaments
Operational incisions
With subareolar abscess - along the edge of the peripapillary field
Intramammary abscess - radial
Retromammary - along the submammary fold
At small sizes an abscess, it is possible to excise it with adjacent inflammatory tissues according to the type of sectoral resection with active drainage of the wound with a double-lumen tube and suturing tightly
Opening of all fistulous passages
With the progression of the process - removal of the gland (mastectomy).

Complications

Fistula formation
Sepsis
Subpectoral phlegmon.
The course and prognosis are favorable
Full recovery occurs within 8-10 days with adequate drainage
After operations, scars remain, disfiguring and deforming the mammary gland.

Prevention

Careful breast care
Compliance with feeding hygiene
Use of emollient creams
Expression of milk.

Synonyms

Mastitis
see also

ICD

N61 Inflammatory diseases of the mammary gland

Disease Handbook. 2012 .

Synonyms:

See what "MASTITIS" is in other dictionaries:

Mastitis- ICD 10 N61.61. ICD 9 611.0611.0 DiseasesDB ... Wikipedia

MASTITIS- (thorax) inflammation of the mammary gland. Mastitis usually occurs as a result of penetration (through nipple cracks) of pyogenic microbes into the mammary gland. Most often it occurs in lactating women and pregnant women. With mastitis, it suddenly rises ... ... The Concise Encyclopedia of the Household

mastitis- breast Dictionary of Russian synonyms. mastitis n. chest Dictionary of Russian synonyms. Context 5.0 Informatics. 2012. mastitis ... Synonym dictionary

MASTITIS- MASTITIS, breast, mastitis, mammitis, mas tadenitis (from Greek mastos female breast), inflammation of the breast. Distinguish sharp and hron. inflammatory processes. Acute inflammation mammary glands can occur at all periods of life, but more often ... ... Big Medical Encyclopedia

mastitis- a, m. mastite mastos breast, nipple. Inflammation of the mammary gland. Krysin 1998. Lex. Michelson 1866: mastitis; BASS 1: suits / t ... Historical Dictionary of Gallicisms of the Russian Language

mastitis- MASTITIS, colloquial. reduced chest ... Dictionary-thesaurus of synonyms of Russian speech

MASTITIS- (from the Greek mastos nipple chest) (breast), inflammatory disease mammary gland in humans and animals, usually as a result of infection through nipple cracks; occurs more often in the postpartum period ... Big Encyclopedic Dictionary

MASTITIS- MASTITIS, husband. Inflammation of the mammary gland. | adj. venerable, oh, oh. Dictionary Ozhegov. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 ... Explanatory dictionary of Ozhegov

Mastitis- (from the Greek mastos nipple, breast) (breast), an inflammatory disease of the mammary gland in humans and animals, usually as a result of infection through cracked nipples; occurs more frequently in postpartum period. … Illustrated Encyclopedic Dictionary

Mastitis- I Mastitis (mastitis; Greek mastos chest + itis; synonymous with breast) inflammation of the parenchyma and interstitial tissue of the mammary gland. There are acute and chronic mastitis. Depending on the functional state mammary gland (Mammary gland) (the presence of ... Medical Encyclopedia

MASTITIS- (breast), acute or chronic inflammation of the mammary gland, usually associated with its infection during lactation. MASTITIS IN HUMANS Mastitis usually occurs in women, although occasionally cystic mastopathy observed in men. Spicy… … Collier Encyclopedia

Books

• Acute purulent lactational mastitis, A. P. Chadaev, A. A. Zverev. The book covers the issues of etiology and pathogenesis, clinic, prevention and treatment of acute purulent lactational mastitis, as well as the principles surgical treatment according to various forms...

This disease often occurs in the first months of a child's life. It proceeds acutely, with an increase in temperature to high values, swelling of the mammary gland, a change in the color of the skin in the area of ​​the areola, and the development of an abscess. With improper treatment, a generalization of the process may occur with the development of a septic component. The incidence of this disease is similar in girls and boys from birth to three years (according to statistics).

According to ICD10 (International Statistical Classification of Diseases), mastitis in newborns has the code P39.0.

Doctors around the world very often refer to this classification. It helps to display statistical data and answer a number of questions related to the diagnosis, treatment, prognosis of various diseases.

Infectious suppuration of the breast baby occurs frequently. May occur in children of both sexes age groups. However, girls under one month are more susceptible to this pathology.

Very often, the development of mastitis in an infant occurs against the background of physiological mastopathy. The cause may be maternal estrogen hormones. They pass on the 7th month of pregnancy from mother to fetus and infants have an imbalance of hormones. With the right approach and hygiene, the disease can go away on its own within a week. Self-medication can lead to infection. The reason can often be the use of disinfecting ointments, compresses that mothers apply to the gland, and tight bandaging of the breast.

Dr. Komarovsky believes that it is important not to harm in cases where you can just leave the child alone and follow simple hygiene rules.

Often, excessive care can cause infection (rubbing with a washcloth, removing rough areas, squeezing out a secret). Purulent mastitis can develop in a weakened child with reduced immunity. Other reasons are tight, rough or dirty clothes, infrequent bathing of the baby.

In addition to external causes, there may be internal ones leading to this pathology. These are concomitant infectious and inflammatory processes in the child's body. They can spread through the blood or lymph. Them timely treatment can prevent the development of new pathologies.

At this age, it is better to refrain from kissing. The infection can enter through the child's mouth and spread internally. The danger of purulent mastitis is associated with the possibility of instant development of sepsis. Risk factors also include a burdened obstetric and gynecological history, urogenital diseases, respiratory viral infections of the mother.

An important place is given today to natural feeding. Breast milk is a powerful immune defense for child's body. Artificial feeding from the first days, it is often a prerequisite for reducing the defenses of the child's body and the development of a purulent infection.

Symptoms of mastitis in a child

The clinical picture of purulent mastitis and breasts is similar, and mothers often confuse these diagnoses.

With physiological mastopathy, which develops as a result of hormonal disruptions, there is no infection and high temperature. The child feels quite normal, calm. The only manifestation is an increase in the size of the mammary glands, but the color of the skin over them does not change. It is possible to highlight some of the secret of gray or white color similar to colostrum. At proper care breasts will often go away on their own without treatment. To do this, mom only needs:

• iron the child's clothes, bed linen well
• use soft cotton fabrics
• bathe your baby regularly

You can, in order to avoid the ingress of bacteria, apply a dry, clean, soft cloth to the mammary gland, changing it often. Do not make compresses (cold, hot), use ointments, folk recipes, squeeze out the secret.

If you do not follow the rules of hygiene, do not pay due attention to caring for the child, or, conversely, over-treat, you can introduce an infection. Suppuration of the swollen mammary gland will already lead to a pathological symptom complex - purulent mastitis.

In infants, this disease often begins on the seventh to tenth day after birth with symptoms of intoxication. High temperature, sleep disturbance, the general condition of the child is unsatisfactory, appetite decreases, diarrhea may join. In parallel, local symptoms develop.

The mammary gland increases, more often on one side. Skin around the areola are initially hyperemic (blush), then become bluish-purple. When touched, the child reacts sharply with screaming and crying. Above the focus, the temperature is increased, later a fluctuation (pulsation) joins - a sign of a formed abscess. When pressed, there may be a release of a small amount of pus, but there is also a spontaneous release of a purulent secret. These symptoms, indicative of a local inflammatory process, develop rapidly, although sequentially. It is necessary to take into account the stage of purulent mastitis for selection right kind treatment.

stages

1. At the initial stage - serous mastitis, local phenomena are poorly expressed by the accumulation of serous fluid, skin color is often not changed. Characterized by swelling of the mammary gland, worsening general condition child, low temperature. At this stage, differential diagnosis is carried out with physiological mastopathy in order to select the correct treatment tactics.
2. The stage of infiltration occurs when the process passes to neighboring tissues, the formation of a diffuse focus, which is accompanied by reddening of the skin, pain and high temperature.
3. Then the foci of infiltration merge, leukocytes accumulate in in large numbers that fight infection, pus forms. Often the process can move to the underlying tissues with the formation of phlegmon and gangrene - a purulent stage.
4. Complications and consequences. At this stage, mastitis in children is dangerous, as it can develop at lightning speed and turn into sepsis. It is necessary to start treatment as soon as possible, and if necessary, on the recommendation of a doctor, agree to a surgical operation. Although such an operation would have undesirable consequences for future mother, but it is carried out according to vital indications and is not discussed.

Diagnostics

For later life, mastitis in girls is more dangerous than in boys because the milk ducts can become blocked, and in the future, asymmetry of the mammary glands can be observed. In adolescence, there are also undesirable consequences: when a girl grows up, becomes a mother, she may have problems with lactation. Then these women will be included in the risk group for oncology, mastopathy.

From additional methods surveys, it is enough to determine general clinical tests. A complete blood count of a child often shows high leukocytosis with a stab shift, increase in ESR. However, due to immaturity immune system, pronounced changes may not be in the blood picture. But this does not exclude an acute infectious process.

Treatment

Tactics medical measures depends on the stage and prevalence of the process.

On the early stages– serous and infiltrative – treatment is often limited to conservative methods. Bed rest is established for the child, cold is applied to the mammary gland. They do a bacteriological study, and prescribe an antibiotic, taking into account the sensitivity of the bacterial flora. In parallel, antipyretic, analgesic and anti-inflammatory therapy is carried out. Usually this medical preparations, where the active ingredient is paracetamol - it can be used from the first days of a child's life. In addition, topical preparations are used - water-soluble ointments that have analgesic, antibacterial effects, while simultaneously promoting healing.

With the formation of phlegmon and abscess of the baby, they immediately operate. The affected areas of the gland are opened, washed and drained. Antibiotic treatment of the child is continued at the discretion of the doctor.

Complementary Therapy

Use funds traditional medicine with the application of various ointments, tinctures, camphor oil is often not recommended by doctors. All this can lead to sad consequences, because. there is a danger of infection and allergens entering the child's body. Therefore, it is better to strictly follow the recommendations of the doctor and not engage in amateur activities.

Restorative, physiotherapeutic treatment is often prescribed during the recovery period. prescribing vitamins, mineral complexes, as well as the correct balanced diet help the child recover faster, get stronger.

Here are the consequences that can be as a result of inattentive attitude and neglect simple rules hygiene of the baby, and the "golden rule of medicine" - prevention of a disease is easier than treatment!