The causes of acute mastitis

Written by Lin Yang
Breast Surgery
Updated on September 07, 2024
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The main causes of mastitis are as follows: First, the accumulation of milk is due to improper breastfeeding techniques or incidental contact with the mammary glands by the child, which causes the milk ducts to close and ultimately leads to the accumulation of milk. Milk is an ideal culture medium that facilitates bacterial growth, leading to mastitis. Second, bacterial invasion occurs when there are cracks or abrasions on the nipple, allowing bacteria to travel along the milk ducts to reach and infect the mammary lobules. Lastly, a decrease in the patient's own immune system can also lead to bacterial infection.

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Written by Lin Yang
Breast Surgery
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Methods for reducing swelling in acute mastitis

Methods for reducing swelling in acute mastitis: First, determine whether the acute mastitis is caused by milk stasis or by bacterial invasion and decreased immune resistance. If it is simply due to milk stasis, nursing can still be continued if the symptoms are mild and the lesion is not severe. However, the affected breast should not be used for nursing, and a breast pump can be used to extract the milk. If the condition is caused by bacteria, it is recommended to apply local moist heat. Penicillin and other saline can be injected around the inflammation. Systemic antibiotics, such as penicillin or cephalosporins, can be used. However, since antibiotics can be secreted into the milk and affect the infant, the use of tetracyclines, aminoglycosides, and sulfa drugs should be avoided.

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Written by Zhang Chao Jie
Breast Surgery
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Which department should I go to for acute mastitis?

For acute mastitis, one should first consult the Department of Mammary Surgery or Thyro-Mammary Surgery. When some hospitals lack a specialized breast surgery department, patients typically consult the general surgery department or gynecology department. If it is during the night or none of the specialized departments are available, then the emergency surgery department should be consulted. Thus, there are multiple relevant departments for acute mastitis. In larger hospitals with specialized departments, one can directly consult the Department of Mammary Surgery or Thyro-Mammary Surgery. During off-hours, nights, weekends, or other emergency periods, it is appropriate to consult the emergency surgery department.

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What medication is used for acute mastitis?

Acute mastitis typically requires three types of medications: topical medications, oral medications, and intravenous medications. Topical medications, also known as local medications, are mainly used to reduce swelling, such as 33% to 50% magnesium sulfate or traditional Chinese medicine topical applications made in Chinese medicine hospitals. Oral medications generally consist primarily of antibiotics, focusing on cephalosporins and erythromycin. Intravenous medications are used when acute mastitis is more severe and oral antibiotics are ineffective, requiring intravenous antibiotic infusions. It is crucial not to purchase medications arbitrarily at pharmacies but to follow the recommendations of a doctor.

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Written by Zhang Chao Jie
Breast Surgery
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Does acute mastitis require infusion?

In cases of acute mastitis, the specific situation must be considered. If it is a simple case of acute mastitis without a significant abscess, without particularly high white blood cell counts, and without pronounced fever, then it is not necessarily required to administer IV fluids. Local applications of magnesium sulfate compresses can be used, and in colder weather, these can be heated for a warm compress. Alternatively, traditional Chinese medicine such as Jin Huang powder can be applied externally and is often sufficient to resolve the issue. However, if the acute mastitis is accompanied by an increase in neutrophilic leukocytes, which requires verification through blood tests, and systemic symptoms such as fever and pain, then antibiotic treatment is necessary, typically administered through IV or orally, though IV is often faster. When acute mastitis is complicated by a breast abscess, not only is IV treatment needed, but also procedures for abscess drainage or incision and drainage. Currently, many minimally invasive methods for draining abscesses and other treatments are employed.

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Breast Surgery
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Acute Mastitis Symptoms and Treatment

Patients with mastitis often feel pain in the breast, with localized redness, swelling, and fever. As the inflammation progresses, there can be chills, high fever, and increased pulse rate, often accompanied by swelling and tenderness of the lymph nodes on the affected side. A routine blood test can show a significant increase in white blood cells. For treatment, if there is swelling, it is recommended to stop breastfeeding and apply topical Levofloxacin. Blood tests should be checked, and if white blood cell count exceeds 10,000, intravenous antibiotics are advised. If below 10,000, oral anti-inflammatory drugs can be taken for symptomatic treatment. After three days, recheck the blood routine to decide on further symptomatic treatment.