Inflammation of the duct of the mammary gland. Non-lactating mastitis: causes, symptoms and treatment in nulliparous women

The treatment of mastitis is aimed at stopping the inflammatory process that develops in the tissues of the mammary gland due to a bacterial infection, and getting rid of its symptoms, in particular breast swelling, pain, fever, etc.

Specific methods of treating mastitis may vary depending on the stage of the disease, but in the arsenal of medicine their range is rather limited.

Mastitis Treatment Methods

To date, for inflammation of the mammary glands, the following are used: conservative, that is, drug treatment of mastitis, physiotherapy, treatment of mastitis with folk remedies, and also - with purulent inflammations - surgical treatment of mastitis.

Since two types of mastitis are clearly classified, the main place is taken by the treatment of lactational mastitis (other definitions: treatment of mastitis in a nursing mother, treatment of postpartum mastitis or puerperal).

But the treatment of non-lactational mastitis - inflammation of the mammary glands, which can develop when the breast is infected in women outside the period of breast milk production after the birth of a child - is not covered enough. Obviously, this is due to the fact that acute inflammation of the breast usually occurs in lactating women: the number of patients with lactational mastitis is almost 87%. While only about 13% of cases are mastitis, which occurs in non-nursing women - both in a mild superficial form and in the form of deep abscesses.

The basis of therapy is a combination of antibacterial drugs with the removal of purulent exudate either by aspiration or surgically through a classic incision.

Mastitis can be treated with ultrasound at the stage of serous inflammation or infiltrative: according to physiotherapists, due to the effect of ultrasound, local blood circulation and tissue metabolism improves.

Such methods are used to treat mastitis in men. And to have an idea of ​​​​what the treatment of mastitis in children should be, read the publications - Mammary glands in children and Mastitis in newborns

Medical treatment of mastitis

It should be noted that some do not distinguish between mastitis and lactostasis (stagnation of milk in the breast). And the fact is that it is with the stagnation of milk in the milk ducts and milk sinuses that the pathological process begins, often turning into postpartum mastitis - inflammation of the glandular tissue of the mammary gland. Moreover, lactostasis, which has almost identical symptoms, is sometimes called non-infectious mastitis, which adds to the confusion in terminology.

By the way, about the confusion: the treatment of catarrhal mastitis in women is problematic, because, firstly, this type is not distinguished by most specialists, and, secondly, such a diagnosis exists only in veterinary medicine ...

But back to lactostasis. With milk stagnation, it is imperative to continue feeding the child and empty the diseased breast by expressing milk, as is done when treating serous mastitis, which is the initial stage of inflammation - serous mastitis. At this stage, some doctors recommend treating mastitis with ointments: gentamicin, synthomycin, heparin, Levomekol, Sulfamekol, Baneocin, Traumeel S.

But the treatment of infiltrative mastitis - the next stage of mastitis in a nursing mother - includes measures to suppress milk production. For this, a drug such as Cabergoline (Dostinex) is used, which is taken twice in laziness at 0.25 mg (for two days). Or Bromocriptine tablets (other trade names - Bromergon, Serocriptine, Parlodel, Pravidel) are prescribed - one tablet (2.5 mg) twice a day (during meals, morning and evening).

To date, drug treatment of mastitis is etiological, since the main causative agents of the inflammatory process in the mammary glands are: Staphylococcus aureus, Streptococcus SPP, Klebsiella pneumonae, Haemophilus SPP, Peptococcus magnus, Entrobacter cloacae, Salmonella SPP. Therefore, the treatment of mastitis with antibiotics is caused by the need to suppress the bacterial infection.

Treatment of acute mastitis, that is, treatment of acute lactational mastitis, will be most effective when using broad-spectrum antibacterial agents.

It is possible to treat mastitis with Amoxiclav (other trade names - Augmentin, Amoklavin, Clavocin) with the penicillin antibiotic amoxicillin and clavulanic acid (which makes it possible to suppress the resistance of Staphylococcus aureus); injection method - injection into a muscle or drip into a vein (625-875 mg twice a day for a week). An antibiotic-aminoglycoside Gentamycin sulfate is used - up to 240 mg per day (into a vein every 8 hours).

Also, with postpartum mastitis, cephalosporin antibiotics are prescribed: Cefalexin (Keflex, Flexin, Ospeksin), Cefotaxime (Cefosin, Clafotaxime, Kefotex) or Cefuroxime (Ketocef, Cefuxime, Zinnat) - 400-500 mg up to three times a day.

For more information on which drugs of this group can be used by nursing, read the article - Antibiotics during breastfeeding

According to breast surgeons, the treatment of mastitis without antibiotics - especially starting from the stage of infiltration - leads to the progression of the inflammatory process and the formation of a purulent focus in the tissues of the breast.

Treatment of purulent mastitis

After the serous stage of inflammation and the formation of an infiltrate, the process passes into the stage of necrosis or suppuration. Treatment of purulent mastitis, which can be nodular, diffuse, phlegmonous, abscessing and gangrenous, requires not only antibiotic therapy.

In many cases, only the treatment of mastitis by puncture gives a positive result, that is, a capsule filled with pus is punctured (with its subcutaneous localization) and aspiration (suction) of the purulent contents is performed. Then, an antibiotic solution with the addition of an anesthetic should be injected into the vacated cavity.

However, it is impossible to make a puncture with a deep (intramammary) occurrence of a purulent focus or phlegmonous mastitis. And then the surgical treatment of mastitis at the abscess stage is used: under general anesthesia, the skin and subcutaneous tissue are dissected and, having reached the abscess, it is opened - with the removal of pus, excision of the tissues affected by necrosis and washing with antiseptics. The wound is sutured and drainage is established. The use of antibiotics after surgery for purulent mastitis continues, and its duration is determined by the attending physician - according to the results of a blood test and normalization of temperature indicators.

Treatment of non-lactational mastitis

Expansion or ectasia of the mammary ducts, complicated by a secondary bacterial infection, is an inflammatory condition of the milk ducts of the breast - periductal (periductal) mastitis, which is typical for patients during menopause.

Treatment of non-lactational mastitis with ectasia of the milk ducts is carried out with antibiotics (orally and parenterally), NSAIDs (non-steroidal anti-inflammatory drugs), antihistamines. If conservative methods are ineffective, they resort to surgical intervention (with a histological examination of a tissue sample for a possible malignant nature of the pathology and long-term observation of patients).

Recurrent abscesses of the mammary gland are noted in focal idiopathic granulomatous mastitis, which, due to the infiltration of the stroma of the gland with plasma cells and epithelioid histiocytes, is also called plasmacytic mastitis. Clinically and radiologically, it can mimic breast cancer, and in such cases, chronic mastitis is treated surgically - sectoral resection.

The same methods of treatment are used for tuberculous mastitis accompanying pulmonary tuberculosis.

Treatment of fibrous mastitis - in the presence of an inflamed papillary node in the lactiferous duct - is only operational.

Inflammation of a breast cyst, as well as lactocele and atheroma, can cause purulent mastitis. In such cases, the treatment of cystic mastitis is no different from the treatment of ordinary acute mastitis (with the exception of the absence of the need to suppress lactation).

The same rules apply when it is necessary to treat mastitis during pregnancy, only you need to consider which antibiotics can be used during pregnancy and which are contraindicated.

Treatment of mastitis with folk remedies

When someone recommends the treatment of mastitis with folk remedies, in most cases they mean remedies that help eliminate milk stasis in women who are breastfeeding. Because the treatment of mastitis at home - with suppuration of the focus of inflammation - is fraught with sepsis.

Thus, the treatment of mastitis with cabbage leaves can reduce swelling and reduce local hyperthermia with lactostasis or the initial, serous stage of mastitis. But how does a woman know that the inflammatory process in her mammary gland has not gone further? In such a situation, applying cabbage leaves to a sore breast will only hurt, because it will take two or three days, during which the inflammation will increase and lead to purulent mastitis.

Treatment of mastitis with camphor oil is possible only with stagnation of milk, if a nursing woman has an excess of it, since camphor in the form of a compress reduces milk production.

The recommended treatment of mastitis with sea buckthorn (in the sense of sea buckthorn oil), as well as the treatment of mastitis with honey, grated beets, rye dough, aloe, apple cider vinegar, etc., which are used externally, will not affect the causative agents of inflammation that develops in the parenchyma of the mammary gland. .

You should not rely on the action of warming compresses, because in inflammatory processes, thermal procedures are absolutely contraindicated. But with milk stagnation (when there is a strong engorgement of the gland), you can use not only a light massage (including a warm shower), but also alternate hot and cold compresses: a hot compress (for seven to eight minutes) helps to improve blood circulation and cleanse milk ducts, and a cold compress (for three minutes) helps reduce swelling and relieve pain. But experts emphasize that this is not done with mastitis, but in cases of milk stagnation during lactation!

ilive.com.ua

How and how to treat mastitis in women? Treatment and signs with a photo

Treatment of mastitis, today, is considered a complex and even ambiguous process. Many women in clinics and forums argue about whether or not to treat inflammation, and most importantly, how to treat mastitis. Moreover, these same questions become the subject of disputes for many qualified doctors.

What is the difficulty in determining and answering the question whether or not to treat an inflammatory process that has begun in the mammary gland of women? We will try to answer as simply and clearly as possible.

The insidiousness of breast inflammation in women, first of all, lies in the incredible variety of different forms and varieties of mastitis.

Indeed, some of the types of breast inflammation in women may not require urgent medical treatment.

However, along with this, there are many types of mastitis, which not only require timely and thoughtful treatment, but even without it, can become much more complicated (various complications or concomitant diseases).

But still, to begin with, we would like to describe situations where the treatment of a problem may consist in immediately contacting doctors, and most importantly, list those actions that are unacceptable if you suspect the development of mastitis.

Actions that absolutely can not be taken with the development of mastitis

If in women who have recently given birth to a child, the first signs of breast inflammation are observed, which is manifested by moderate soreness of one gland, an increase in body temperature, if at the same time women experience standard symptoms of intoxication, the most logical thing that such a woman should do is to urgently consult a qualified doctor .

The same should be done if women have redness and an increase in the size of one (painful) gland, which is noticeable even in the photo.

This condition is mandatory, primarily because it is practically impossible to differentiate mastitis from lactostasis on its own.

And all because the primary symptoms of mastitis are almost identical to the state of stagnation of milk in the milk ducts of the breasts of women.

Moreover, mastitis itself has many variants of development, despite the fact that the symptoms of various forms of the disease are very similar to each other and differ, first of all, in their intensity.

• Panic, and as a result, stop lactation without consulting a doctor. In particular, the independent use of drugs such as Dostinex, or Bromkriptin is prohibited.
• Without establishing the causes of discomfort in the chest, assign yourself any thermal procedures directly to the disturbing mammary gland. We are talking about excessively hot baths, contrast showers, thermal compresses. This also includes any other, thermal nature, alternative treatment, which is often advised by our neighbors, grandmothers and girlfriends.
• We repeat - it is strictly forbidden to apply any heating pads directly to the area of ​​\u200b\u200binflammation of the breasts of women.
• Self-use as a treatment for suspected mastitis, “honey cakes” that warm and increase blood flow in the chest of women, heat compresses on cabbage leaves, and other, not always justified, folk remedies.
• Recklessly and too sharply limiting oneself in daily fluid intake, this can only threaten with possible dehydration and increased symptoms of intoxication, especially if discomfort in the chest is associated with other inflammatory processes that do not occur in the mammary gland.
• Immediately (without an adequate examination and consultation with a doctor) begin self-treatment of problems with the use of powerful antibacterial drugs.

Women who notice the primary signs or obvious symptoms of mastitis in themselves should be aware that the final results of the treatment of the affected breast will directly depend on the timing when adequate therapy is started.

For example, if a woman who is faced with chest discomfort and who has found other signs of inflammation of the mammary gland receives adequate medical assistance in the first day or two (from the moment when obvious symptoms of the disease appeared), then the chances of getting rid of the problem are highest.

Moreover, with the timely receipt of adequate therapy, a positive result can be practically guaranteed, without the need for surgical intervention.

But still, the question remains how to cure mastitis, correctly, without harming your health, and without aggravating the situation.

Conservative (non-surgical) method of treating mastitis

In this case, the main principle that represents the correct treatment of inflammation of the mammary gland in a woman is the principle of timely access to a doctor and constant (regular) emptying of the mammary glands.

At the initial stages of the problem, feeding a child from a “painful” gland is considered absolutely safe for the child himself!

In all cases, without exception, with an increase in body temperature associated with an inflammatory process in the mammary gland, treatment involves the use of effective antipyretics.

In certain forms of the disease, doctors can also prescribe the use of local treatment, including the treatment of the nipples and the full treatment of their cracks (as a rule, the use of agents such as Bepanten or Purelan-100 is most often recommended for this).

It is very important to say that the use of certain forms of antibiotics in the development of inflammation in the mammary gland is not at all strictly mandatory and the main treatment for all forms of mastitis without exception.

Moreover, often the use of antibiotics is postponed by doctors if possible, because often they may not be needed.

Despite such an encouraging statement, the treatment of inflammatory processes in the mammary gland should be carried out under the supervision and control of qualified doctors.

Surgical treatment of mastitis

Unfortunately, in some cases, it is not possible to get rid of breast inflammation through alternative treatment, and even through powerful antibiotic therapy.

As a rule, with prolonged failure of conservative therapy, with the development of more complex purulent forms of the disease, with the development of numerous complications, doctors are faced with the most difficult types of inflammation to treat.

And then, with such a seemingly harmless lactation disease as mastitis, there can be only one treatment - surgical.

Most often, surgical options for the treatment of certain forms of mastitis consist in the most accurate opening of purulent foci of inflammation, and in their mandatory subsequent drainage.

What is necessary for the speedy removal of accumulations of pus from the affected mammary gland. In such cases, for the purpose of full pain relief, general anesthesia is almost always used.

But, for example, the so-called puncture method of surgical intervention for this disease is considered inappropriate, since this can lead either to the progress of the disease or to its relapse.

Actually, therefore, most physicians are confident in the urgent need for the timely implementation of radical surgical treatments for purulent foci of inflammation.

omastopatii.ru

Non-lactation mastitis in women: symptoms and treatment with antibiotics and folk remedies

As many have heard, breast inflammation can be aseptic and purulent, associated with lactation in women, or not associated.

In the form of specific diagnoses, these conditions are usually referred to as non-purulent mastitis and purulent, as non-lactational mastitis and lactational, respectively.

However, today we want to talk about mastitis not associated with the process of breastfeeding (lactation).

These are breast problems that occur in non-breastfeeding women, men, and even children.

The main reasons for such a diagnosis, outside the time of lactation, can be:

• Certain periods in life, sexual crises in newborns, puberty in adolescents, the period when lactation is stopped, menopause in older women, etc. In general, these are conditions when non-lactational mastitis is borderline close to the physiological norm.
• Certain chest injuries, when there is an infection of the breast tissue, microbes entering from the outside.
• endogenous causes. When certain microbes enter the mammary gland of non-nursing women with direct blood or lymph flow, from some other foci of infection in the body (this is the so-called secondary mastitis).
• Diseases of an endocrine nature, which can primarily lead to certain forms of mastopathy, and secondarily to the development of inflammation in the mammary gland of non-lactating women.
• The consequences of surgery, say, with mastopathy, when the infection is introduced into the chest of women, as a result of a medical error or improper postoperative care.

Of course, mastitis during lactation is a more common phenomenon than mastitis in a non-lactating woman.

Nevertheless, this disease occurs, and just like in other cases, it can cause a lot of problems for patients. And so, this disease requires its detailed consideration.

Symptoms of non-lactational mastitis

Non-lactational mastitis can occur in both sexes, but more often this form of the disease overtakes women who are faced with certain hormonal disorders.

It should be noted that most often this type of mastitis is somewhat easier than mastitis that develops during lactation.

This form of the disease passes into more complex purulent stages much less frequently (than problems during lactation) and can be treated more quickly (even with folk remedies), and sometimes, if this is a physiological condition, treatment, in principle, is allowed not to be used.

The symptoms of this disease, to a greater extent, depend on what form of the disease you have to deal with.

So, non-lactational serous mastitis can be a borderline condition that practically fits into the norm. Symptoms of this form of the disease can be barely noticeable, and rather resemble mastopathy. Usually in this condition, a woman may complain of moderate swelling or swelling of the chest, moderate pain in such, a barely noticeable increase in body temperature (37 degrees) and nothing more.

Infiltrative non-lactational mastitis will be somewhat more pronounced in its clinical picture. So, the symptoms of this form of the disease will include a noticeable increase in temperature, palpable pain and heaviness in the chest.

The chest may be warm or even hot to the touch, and immediately above the seal in such, there may be some reddening of the skin.

Purulent non-lactational mastitis will have even more pronounced symptoms, and an even more severe condition of the woman herself, and will be very similar to the pathological condition that flutters during lactation.

How is non-lactational mastitis treated?

It is quite clear that the treatment of various forms of a disease such as non-lactational mastitis will depend on the stage of the disease, on its form and on the presence of concomitant diseases.

Physiological forms of inflammation of the mammary gland make it possible to postpone treatment, giving preference to dynamic monitoring of the state of health.

Treatment of serous forms of this type of mastitis may well be carried out with folk remedies. For example, doctors may advise women to take herbal teas, from herbs that have a powerful antiseptic and bactericidal effect. Sometimes infusions of such herbs can be used as compresses on a sore chest.

In any case, before starting the treatment of any problems associated with the mammary gland, it is strongly recommended to consult an experienced doctor who, firstly, will determine the exact diagnosis, and secondly, select the ideal treatment.

It is important to understand that the treatment of mastitis problems can differ dramatically depending on whether it is a serous form of the disease or purulent.

Suppose an infiltrative form of inflammation of the breast is treated with folk remedies and using antibiotics. But, at the same time, it is important to understand that the combination of various means and methods in treatment should be thoughtful and perfectly competent.

And of course, one cannot but say that a purulent non-lactation process in the mammary gland is treated primarily using antibiotics. The use of other means for treatment is rather symptomatic or concomitant.

It is very important, in this case, that the drug is correctly selected for a particular woman in order to prevent the development of more complex forms of inflammation.

After all, with inadequate treatment of the disease, there are risks of developing emergency conditions, and first of all, an abscess. Note that with the most neglected and complex forms of mastitis, patients may even require surgical assistance from surgeons.

As you understand, the described disease (as well as any other) is more logical to foresee and try to prevent. And for this, it is enough to use all measures to prevent the development of inflammation of the mammary gland:

• Firstly, it is very important to treat any infectious processes in the body in a timely manner.
• Secondly, women need to adhere to all the rules of hygiene during lactation.
• Thirdly, to avoid injuries and even just blows to the mammary gland.

In addition, the prevention of any form of non-lactational mastitis can also be attributed to the timely visit to the doctor in case of the slightest changes in the breast and, of course, the overall strengthening of the woman's immune system.

omastopatii.ru

How to cure mastitis at home?

Mastitis is an inflammation of the mammary glands in women, which is caused by an infection. This pathological process tends to spread to the surrounding tissues, and if left untreated, it can lead to a complication in the form of sepsis. What are the causes and symptoms of such a disease, and is it possible to treat mastitis with folk remedies at home?

Types of mastitis

In most cases, inflammation of the mammary glands develops after childbirth and is associated with increased milk production. This mastitis is called lactational, it complicates the postpartum period, and occurs in 7% of new mothers. Most often, it is unilateral, that is, it affects only one breast, but recently there has been a tendency to develop a bilateral process.

There is also non-lactational mastitis, when inflammation is not associated with breastfeeding and milk production. In this case, the process does not have such a pronounced clinical picture, complications in the form of the spread of the process are quite rare, but it often turns into a chronic variant of the course. Cases of the development of the disease in newborn girls are described - in this case, the cause of the pathology is the intake of an excess amount of hormones from the mother's body.

Why does mastitis develop?

The causes of inflammation of the mammary glands in women may be different, but they determine the type of mastitis. It can be lactational and non-lactational, acute and chronic, serous and purulent.

Postpartum (lactational) mastitis

Lactational mastitis is most often caused by Staphylococcus aureus. Infection occurs through contact with carriers of this pathogenic flora (maternity hospital workers, roommates).

In order for staphylococcus aureus to cause mastitis in women on the skin of the mammary glands, there are predisposing factors:

• mastopathy;
• scars after surgical interventions;
• congenital features of the structure of the mammary glands;
• difficult pregnancy;
• pathology in childbirth;
• chronic diseases;
• sleep disturbance and neurological problems in the postpartum period.

At risk for the development of mastopathy in women are primiparas, since milk production in this case is most often imperfect. The fact that a young mother does not have the skill to properly feed a child and does not know how to express herself also plays a role.

Non-lactational form of the disease

The appearance of such a disease as non-lactational mastitis occurs with a decrease in the immune forces of the body. The reasons for this are as follows:

• hypothermia;
• severe infectious process;
• chronic concomitant diseases;
• constant psycho-emotional and physical overload;
• microtrauma of the mammary glands.

But the main cause, as well as with lactational mastitis, is an infection (Staphylococcus aureus).

How mastitis manifests itself

The symptoms that accompany inflammation of the mammary glands in women depend on the stage of the disease. Both lactational and non-lactational mastitis begins with a serous form, which is sometimes difficult to distinguish from milk stasis. In both cases, there is heaviness in the chest, a feeling of tension, and when you feel it, you can feel a slight induration.

Inflammation of the milk ducts (mastitis) most often occurs in the postpartum period in nursing mothers, much less often in non-nursing women, and very rarely in pregnant women. Currently, the incidence of mastitis has increased significantly in women over thirty years of age. Doctors explain this by the fact that women are increasingly giving birth for the first time at this age.

Types and causes of inflammation of the milk ducts.

Mastitis is acute and chronic. In turn, acute mastitis is serous (initial), infiltrative, abscessing, phlegmanous and gangrenous. The form of chronic mastitis can be purulent and non-purulent. Quite rarely, women have chronic purulent mastitis.

With inflammation of the milk ducts, the causative agent of infection is staphylococcus aureus. It can cause disease on its own or in combination with Escherichia coli. People with skin abscesses or other foci of infection can transmit the infection to women who have abrasions or cracks on the nipples through underwear, care items, and more. Much less often, infection occurs by getting pathogenic microbes from the woman's own foci of infection (sinusitis, chronic tonsillitis) through the lymph and blood.

Violation of the outflow of milk and a weakened body of a woman in the postpartum period contribute to the emergence and development of the inflammatory process. Violation of the outflow of milk occurs in women (especially in primiparas) due to insufficient development of the milk ducts, abnormal structure of the nipples and disruption of the mammary gland.

The symptoms that occur with the initial form of acute mastitis are different from the symptoms that occur with lactostasis. So with lactostasis, tension and swelling of the mammary gland is noted, painful and mobile seals can be felt. Expressing milk is painful but free. After pumping comes relief. The temperature may rise slightly, but the general condition does not worsen. The penetration of pyogenic bacteria into the gland after two to four days leads to the appearance of serous or nasal. The disease begins acutely: the temperature rises sharply, there are severe chest pains and chills. The mammary glands are painful and enlarged to the touch. Such mastitis should be treated under the supervision of a doctor, because if it is treated incorrectly, then in just a few days it will develop into an infiltrative form. When examining the mammary gland, redness and swelling of the skin are observed, and inside there is a dense formation. The process quickly turns into a purulent one, a very high temperature is maintained. The infiltrate is unsteady on palpation, which indicates the presence of fluid or pus, which is limited from the rest of the tissues by a capsule.

Phlegmanous mastitis is characterized by an increase in temperature to critical levels, the presence of pus that is not separated by a capsule from other tissues, a sharp increase in the mammary gland, swelling, luster and redness of the skin, as well as an increase in nearby lymph nodes.

But a particularly serious condition is observed with gangrenous mastitis. The general condition of the woman is very serious, tissues die off: the skin of the mammary gland is covered with blisters filled with bloody contents and areas of dead tissue.

The manifestations of the chronic course of purulent mastitis are mild. There may be soreness and enlargement of the mammary gland, sometimes the temperature rises slightly and nearby lymph nodes become inflamed. The chronic course, which is a consequence of acute inflammation, can be manifested by the formation of fistulas with the release of pus.

Treatment of the disease.

Treatment depends on the phase of the disease. Before the formation of pus, anti-inflammatory treatment is carried out. With the help of a bra or bandages, the mammary gland should be given an elevated position, to improve milk expression, physiotherapy is carried out, drugs are prescribed that help expand the ducts in the mammary gland, as well as antibiotics. Sometimes, in order to prevent the formation of an abscess, an infiltrate is cut off with a solution of antibiotics with novocaine.

With an abscess formed, such treatment is useless, it is necessary to perform an operation to open it. Further treatment is the same as in the treatment of purulent wounds.

Chronic purulent mastitis is also treated promptly. With non-purulent chronic mastitis, conservative treatment is first performed. If it does not help, a sectoral resection of the mammary gland is performed, i.e. remove the infiltrate simultaneously with adjacent tissues.

goldstarinfo.ru

Galactophorite

Galactophoritis is one of the variants of mastitis, in which the inflammatory process is localized in the ducts of the mammary glands. Manifested by pain in the affected chest, serous-purulent or purulent discharge from the nipple, fever to subfebrile and febrile numbers. For diagnosis, cytological and microbiological examination of secretions from the mammary gland, contrast ductography are used. The treatment regimen for galactophoritis involves the appointment of antibacterial, anti-inflammatory, antihistamine, antimycotic, immunocorrective drugs and hormone therapy. In resistant cases, ductal lavage and selective ductolobectomy are performed.

Galactophoritis (intracanalicular or intraductal mastitis) occurs mainly in patients under the age of 45-47 years. Its clinical manifestations differ depending on the patient's belonging to a certain age group. In women from 18 to 35 years old, the lactation and post-lactation variant of inflammation of the breast ducts with more acute symptoms prevails. Patients over the age of 35 are more likely to suffer from protracted non-lactational galactophoritis, which occurs against the background of secernation of the mammary gland. In such cases, secretory mastopathy becomes the leading cause of the disease, which is detected in 30-40% of women with an inflammatory process in the milk ducts.

Causes of galactophoritis

Intraductal inflammation of the mammary glands in most cases is caused by the multiplication of pathogenic microflora in the lumen of the milk ducts and the surrounding connective tissue. The main causative agents of the disease are microorganisms from the group of staphylococci. Less commonly, streptococci, Escherichia coli, Proteus, fungi, bacteroids are sown from the lesion. Aseptic variants of galactophoritis are extremely rare. The inflammatory process in the ducts of the mammary gland usually develops with a combination of several prerequisites - the presence of a secret in the lumen, a violation of its outflow and seeding of tissues with pathological flora. Predisposing factors for the disease are:

• Laktostasis. Milk stagnant in the milk ducts of a lactating woman is a favorable nutrient medium for the development of Staphylococcus aureus and other microorganisms. Concomitant metabolic disorders trigger the mechanisms of local tissue inflammation. Galactophoritis with lactostasis usually quickly turns into other forms of lactational mastitis.
• Secerating mammary gland. Microorganisms can multiply not only in breast milk, but also in other types of secretions. The production and accumulation of serous fluid and colostrum-like secretions are observed with hyperprolactinemia, secretory mastopathy, intraductal papillomas, malignant neoplasms of the breast, and oral contraceptives.
• Elongation or compression of the milk ducts. The likelihood of stagnant breast secretions is increased in women with abnormally long or tortuous ducts. The causes of the violation of the outflow of secretions can also be the crushing of the lactiferous passages by volumetric neoplasms - cysts, fibroadenomas, nodes in fibronodular mastopathy and other neoplasias.
• Chronic inflammatory diseases. With non-lactational forms of galactophoritis, pathological microorganisms enter the breast tissue by hematogenous or lymphogenous routes from foci of acute or chronic infection. In patients with intraductal mastitis, acne, diseases of the ENT organs, the urogenital area, the gastrointestinal tract, etc. are often detected.
• Decreased immunity. Patients with immunodeficiency states are more prone to the occurrence and protracted course of inflammatory reactions. The deterioration of the body's defense reactions is observed with chronic overwork, stress, long-term somatic diseases, taking immunosuppressive drugs and radiation exposure.
• Bacterial pollution of the environment. The source of infection is asymptomatic carriers of the so-called hospital infections, from which pathogens enter the body of a woman through environmental objects, underwear, medical instruments and equipment. This factor plays a particularly significant role in the development of lactational galactophorites.

Stagnation of milk and pathological secretion of the mammary glands provokes the development of an aseptic inflammatory reaction. In the affected area, there is increased vascular permeability, signs of metabolic acidosis, accumulation of extracellular fluid. With non-lactational galactophoritis, the situation is aggravated by progressive sclerosis and hyalinization of the connective tissue of the affected areas. There is compression and deformation of the glandular lobules, which leads to increased congestion and the formation of cysts. Microbial contamination of tissues is accompanied by an increase in the processes of alteration due to exposure to bacterial toxins, desquamation of the ductal epithelium, a further increase in the permeability of the walls of the milk passages and the spread of the infectious process to the periductal tissue.

Classification

When systematizing the clinical forms of galactophoritis, the direct factors that provoked the occurrence of intraductal mastitis, the rate of development and the severity of pathological symptoms are taken into account. To select the optimal medical tactics, specialists in the field of mammology distinguish the following options for intracanalicular inflammation of the breast:

• Lactational galactophoritis. The form of the disease, characteristic of the period of breastfeeding. It differs by more acute clinical manifestations and a rapid transition to other variants of lactational inflammation of the mammary gland.
• Non-lactation galactophoritis. Occurs due to causes not related to lactation. It is prone to a protracted and chronic course with less pronounced clinical symptoms. Often, the inflammatory process does not tend to spread.

Clinical manifestations of lactational intraductal mastitis have symptoms typical of such inflammations. The patient experiences severe pain in the chest on the side of the lesion, her temperature rises to + 38 ° C or more, redness of the skin over the inflamed duct is noted. Unlike other types of mastitis, there is no noticeable swelling and infiltration of breast tissues with galactophoritis. In some women, the affected lacteal passage is palpable in the form of a round or cylindrical, sharply painful seal. As the disease develops, symptoms of other forms of lactational inflammation of the mammary glands may appear, up to signs of purulent mastitis.

The main symptom of non-lactational galactophoritis is the presence of pathological discharge from the chest, combined with moderately severe local pain, subfebrile condition. Discharge from the affected duct is usually yellowish, purulent. Patients often have a background serous, less often colostral discharge from other ducts (trace post-lactational galactorrhea). However, if the inflammatory process complicates the course of other diseases, the secret may be brown (in the presence of cysts and breast cancer) or greenish (in patients with mastopathy).

Complications

With untimely or inadequate therapy, galactophoritis can spread to the glandular tissue and turn into generalized forms of breast inflammation. The spread of infection is more often observed in lactation variants of intraductal mastitis. Sometimes long-lasting galactophoritis causes breast deformity. A serious complication of protracted and chronic forms of inflammation against the background of dyshormonal processes is deep dystrophy of mammary gland tissues and the appearance of foci of atypical proliferation against this background. This condition increases the risk of tissue malignancy with the development of ductal breast cancer.

Diagnostics

The main task of the diagnostic stage is the early detection of galactophoritis to prevent its transition to common forms of inflammation and the prevention of oncopathology. The diagnosis is complicated by the absence of specific symptoms and the scarcity of clinical manifestations in the chronic course of the disease. In diagnostic terms, the most informative:

• Cytology of a nipple smear. Intraductal inflammation is evidenced by the detection of macrophages, polynuclears, plasma and mast cells, and desquamated ductal epithelium in the secretion of the mammary gland.
• Microbiological analysis of the secret from the nipple. The causative agent can be determined both by smear microscopy and by the results of its inoculation on nutrient media. Bakisledovanie allows you to determine the sensitivity of the flora.
• Ductography. Compared with mammography and sonography, contrast galactography well visualizes the pathomorphology of the processes occurring in the lactiferous duct and the lobe of the mammary gland drained by it.

To clarify the reasons that led to the occurrence of galactophoritis, an additional blood test is prescribed for the content of sex hormones (estradiol, progesterone, FSH, LH, prolactin), ultrasound of the mammary glands, mammography in two or three projections, cytological examination of the biopsy. The disease is differentiated with other forms of lactational and non-lactational mastitis, ectasia of the milk ducts, mastopathy, intraductal papillomatosis and other intraductal breast tumors, Paget's disease. In difficult diagnostic cases, a gynecologist, surgeon, endocrinologist, oncologist, infectious disease specialist are involved in the diagnosis.

Treatment of galactophoritis

The main therapeutic tasks in the detection of intracanalicular mastitis are the sanitation of the focus of infection and the elimination of the causes that provoked the development of the disease. Recommended complex treatment with the appointment of drugs in combination with physiotherapy and, if necessary, drainage of the milk ducts. The treatment regimen includes the following groups of drugs:

• Antibiotics. A competent choice of antibacterial agents, taking into account the sensitivity of microorganisms, allows you to quickly suppress inflammation in the affected milk ducts.
• Anti-inflammatory drugs. The purpose of NSAIDs is aimed at inhibiting the secretion of inflammatory mediators, reducing pain.

To prevent possible complications of antibiotic therapy, antihistamines and antimycotics, eubiotics are recommended. The appointment of immunocorrectors and vitamin-mineral complexes positively affects the faster achievement of a therapeutic result. With lactational galactophoritis, drug therapy is supplemented with decantation of the mammary gland, normalization of the feeding regimen, physiotherapy procedures (UVR, ultrasound, oil-ointment dressings). Since chronic non-lactational forms of inflammation usually develop with hormonal disorders, in the presence of such a pathology, an appropriate variant of hormone therapy is selected. In the treatment of such patients, laser and ozone therapy is effective.

Persistent cases of the course of the inflammatory process are the basis for the use of more radical procedures and surgical interventions. In the absence of the effect of complex drug therapy, patients with secretory mastopathy perform duct lavage with simulated PVC catheters. The flow bed is usually sanitized with a solution of dimexide. In the case of deforming and repeatedly recurring galactophoritis, selective ductolobectomy is indicated to prevent deformity of the mammary glands and the development of malignant neoplasia.

Forecast and prevention

The prognosis is favorable. The appointment of complex conservative treatment provides a complete cure in 90-92.5% of patients. Even with a resistant course of galactophoritis, selective ductolobectomy provides a stable therapeutic result. For the prevention of intraductal mastitis, it is recommended to observe the technique and regimen of feeding the child, sanitation of foci of chronic infection before childbirth, compliance with the rules of personal hygiene by the woman in labor, aseptic and antiseptic standards in obstetric hospitals. To prevent lactostasis in primiparas, decanting of the mammary gland is used. Patients with secerating breasts should be examined by a mammologist for timely treatment of the disease that caused pathological secretion.

www.krasotaimedicina.ru

External manifestations of inflammation of the mammary glands

Inflammation of the mammary gland or, as it is also called, mastitis manifests itself very sharply. A woman begins to suffer from severe chest pains with hardening and hyperemia of her skin, which is usually accompanied by fever and a general deterioration in well-being. This condition requires immediate medical attention, otherwise the consequences can be dire. It is imperative to treat inflammation. Despite the fact that this disease is considered female, a similar condition is noted in men.

Causes of inflammation

Inflammation of the breast quite often overtakes nursing mothers. Especially often it is diagnosed in the first weeks after childbirth, when lactation is just beginning to improve. The reasons for its development may be as follows:

• The appearance of lactostasis - stagnation of milk due to blockage of the milk ducts.
• Incorrect attachment of the baby to the breast.
• Anatomical features of the structure.
• Any damage to the nipple is the entrance gate for infection.
• Injury to the milk ducts.
• Hypothermia of the chest.
• The presence of chronic foci of infectious inflammation in the body.
• Decreased immunity.
• Blockage of the milk ducts due to the large breast size in a nursing mother.

The most common cause of mastitis in nursing mothers is neglected lactostasis, which is a favorable environment for the reproduction of pathogenic microbes that have penetrated into the mammary gland through the nipple injured by improper attachment of the baby. Therefore, its treatment should be mandatory.

Erysipelatous inflammation of the breast can overtake women aged 15 to 50 years, including those who have not yet known the joys of motherhood. The causes of this disease may be as follows:

• Hormonal imbalance in the body.
• Pathologically low immunity.
• Severe hypothermia of the mammary gland.
• Injury to the nipple and entire breast.
• Exacerbation of sciatica.
• The presence in the body of foci of chronic infection.
• Benign and malignant tumors of the breast.
• Stress or strong emotional experience.

All women should be very attentive to the state of their health, not to do stupid things and avoid such situations. And when the first symptoms appear, immediately visit a doctor in order to receive qualified treatment.

The causes of such inflammation in men are endocrine disorders, urological diseases, injuries and dysfunctions of the reproductive organs. Another reason for the development of breast inflammation in men will be hormonal imbalance.

Symptoms and signs

Any inflammation of the mammary gland, including erysipelas, cannot go unnoticed. The clinical picture of mastitis in women of any severity is always quite bright. To indicate that the mammary gland is inflamed, the following symptoms may appear:

• Severe chest pain.
• Hardened nipple.
• Increased sensitivity of the mammary glands.
• The appearance of seals, which can be on the entire chest.
• Hypermia of the skin at the site of inflammation.
• An increase in the size of the breast due to edema.
• Enlargement of nearby lymph nodes.
• Increase in body temperature.
• General deterioration of well-being.

In the blood test in women, leukocytosis is noted, feeding the baby becomes painful and often impossible. There are also specific symptoms that allow you to differentiate erysipelas according to its different types, which allows you to prescribe an effective treatment.

In men, the main sign of inflammation will be a pathological enlargement of the mammary glands, very similar to edema.

Types and forms of inflammation

Inflammation in the mammary gland in women is primarily divided into lactational and non-lactational. Its form can be acute and chronic. Depending on the symptoms, the following types of mastitis are distinguished:

• Serous - in which there is no focus of infection, but it must be treated immediately.
• Acute infectious - develops due to infection through the damaged nipple deep into the mammary gland.
• Chronic - develops if adequate treatment has not been prescribed.
• Abscess - occurs against the background of serous or infectious inflammation.
• Phlegmonous - characterized by general intoxication of the whole organism.
• Gangrene of the breast is a condition requiring urgent surgical intervention.

Only a qualified doctor can diagnose erysipelas in women and make an accurate diagnosis. Therefore, when the first symptoms appear, you need to hurry to see him in order to receive proper treatment.

Primary mastitis in men is exclusively serous.

Nipple inflammation

Separate words deserve inflammation of the nipple - an ailment that quite often overtakes breastfeeding young mothers. Its causes are primarily injuries that appear when the baby is improperly attached to the breast or during the period of lactation. Through cracks, abrasions and chafing, if they are not treated, pathogenic microorganisms penetrate deep into its soft tissues, causing an acute inflammatory process. The situation can be aggravated by improperly selected underwear or insufficient breast care.

Signs that the nipple is inflamed in women are quite bright:

• engorgement;
• redness and swelling of the areola;
• a feeling of fullness in the mammary gland;
• severe pain;
• increase in body temperature.

Any inflammation of the nipple, even mild, must be urgently treated. Otherwise, the disease will progress, gradually capturing the entire breast, which will make it impossible to continue breastfeeding due to severe pain, discomfort and the unsatisfactory condition of the young mother. In men, inflammation of the nipples occurs due to injury.

Diagnosis and treatment

Modern diagnostic methods allow the mammologist to make an accurate diagnosis already at the first examination. In addition to the traditional palpation method for examining women and men, modern clinics and medical centers use:

• mammography;
• biopsy.

All these modern hardware diagnostic methods allow you to accurately diagnose and not confuse erysipelas of the mammary gland with other equally dangerous ailments.

Treatment of mastitis should be started immediately to avoid the occurrence of a purulent focus in the chest. This will be especially important with an infectious lesion. For this, a woman is prescribed a powerful antibiotic therapy, which quickly alleviates the general condition and relieves pain.

At the same time, it is not necessary to stop breastfeeding the baby - doctors in this case prescribe drugs that are compatible with breastfeeding. Mastitis can also be treated locally, using special ointments and compresses for this.

Women can alleviate their condition with folk methods, such as applying a cabbage leaf or plantain to a sore breast, applying a compress with carrot juice or aloe, etc. Therapy for mastitis in men begins with the elimination of its root cause.

Timely treatment will allow you to quickly get rid of the inflammatory process in the mammary gland and prevent the development of complications. With advanced forms of mastitis, only surgical intervention will be effective.

prozhelezu.ru

Inflammation of the breast in women

Inflammation of the mammary gland in women (mastitis) is a disease that develops in 80% of cases during breastfeeding. Less commonly, non-nursing women experience mastitis, sometimes it occurs in newborn girls. Without adequate and timely therapy, the disease leads to serious health consequences. Let's figure out what are the main causes and symptoms of the development of inflammation in the mammary glands and how to properly treat it in order to prevent complications.

The reasons

The female body is fragile and susceptible to the influence of various adverse factors. Women's health is especially vulnerable in the postpartum period. It was at this time that many young mothers are at risk of developing lactational mastitis caused by lactostasis. It occurs as a result of stagnation of milk in the ducts of the mammary gland due to anatomical defects in the nipple or improper attachment of the baby to the breast. If lactostasis is not eliminated within 2-3 days, mastitis develops.

The inflammatory process can also begin when an infection enters through cracks in the nipple if hygiene standards are not observed.

The provoking factors for the onset of the disease in women outside lactation are:

• the presence of a chronic infection in the body (pyelonephritis, tonsillitis, sinusitis, caries);
• hormonal disorders;
• hypothermia;
• low immunity;
• chest injury;
• breast tumors;
• piercing or implant.

Most often, the disease occurs as a result of exposure to several adverse factors at once.

Whatever the factors that influenced the development of mastitis, the true cause of inflammation is the penetration of an infection into the breast tissue, usually staphylococcal or streptococcal. Pathogenic bacteria can enter through damaged breast skin or through the general bloodstream.

The course and forms of inflammation of the mammary gland

Like any other inflammatory process, mastitis has several stages of development. The following successive stages are distinguished:

• serous;
• infiltrative;
• purulent;
• phlegmonous;
• gangrenous.

As the disease progresses, symptoms increase and the likelihood of the most dangerous complication, sepsis (blood poisoning), increases.

The beginning of the inflammatory process in the mammary gland is difficult to miss and go unnoticed. Therefore, treatment usually begins in the acute form of the disease, and the chronic form of inflammation is rare. It develops against the background of prolonged ineffective treatment of purulent mastitis or with a strong decrease in immunity.

Each stage and form of the disease has its own signs and symptoms.

Symptoms

The first signs of inflammation of the mammary gland appear at an early stage of the disease - serous. Her symptoms are:

• enlargement and compaction of the mammary gland;
• soreness and a feeling of fullness of the chest, which do not disappear (and sometimes intensify) after feeding the baby and expressing milk;
• increase in body temperature up to 380C.

The lack of treatment leads to the fact that the woman's condition deteriorates sharply, the symptoms increase:

• the temperature rises above 390C;
• on palpation in the depths of the gland, an inflammatory compaction is felt - an infiltrate;
• the skin over the site of inflammation turns red;
• migraine, severe weakness appear.

With ineffective therapy of the infiltrative form of mastitis, the disease turns into a purulent form with the formation of an abscess, the symptoms of which become threatening:

• the breast significantly increases in size, swells, there is severe redness and pain;
• body temperature reaches 400C and above, it often changes abruptly: it drops sharply with profuse sweating, then rises again to high numbers;
• the phenomena of intoxication are growing: nausea, vomiting, severe headaches;
• enlarged regional lymph nodes.

With phlegmonous and gangrenous forms of mastitis, infection spreads to the entire area of ​​\u200b\u200bthe gland. The symptomatology of the purulent form is supplemented by:

• persistent increase in heart rate up to 120-130 beats per minute;
• the whole chest becomes hard, sharply painful;
• the appearance of a purple-cyanotic shade of the skin of the chest (with phlegmon), then the appearance of blisters with bloody contents (with gangrene) - tissue necrosis.

The health and life of a woman is in serious danger - only urgent surgical intervention can save her.

The clinical picture of the chronic form of inflammation of the mammary gland is not pronounced:

• the chest is slightly enlarged, moderately painful;
• subfebrile temperature (up to 37.80C);
• to the touch, a dense infiltrate is found in the area of ​​\u200b\u200bthe gland;
• slightly swollen lymph nodes;
• the general condition of the woman is slightly disturbed.

Mastitis usually develops in one mammary gland, less often in both (in 10% of women).

Inflammation of the mammary gland in a nursing mother

Lactational mastitis in 96% of women develops after the first birth. Most often this happens at 2-6 weeks of breastfeeding. The first signs of inflammation in the mammary gland resemble in the clinical picture a blockage in the ducts - lactostasis: severe engorgement of the gland, accompanied by painful sensations. It is possible to understand that the process has passed into a pathological form and has taken on an inflammatory character, according to the following signs:

• pain does not improve after feeding or pumping;
• the skin of the chest turns red;
• the temperature difference in the armpits on both sides is the same (with lactostasis, the temperature from the affected breast is higher);
• body temperature rises above 380C and lasts more than a day;
• the general condition of the woman worsens, appetite disappears, sleep is disturbed.

Laktostasis is not a reason to stop breastfeeding. Active attachment of the child to the sore breast in combination with massage helps to quickly eliminate congestion in the mammary gland and alleviate the condition of the woman.

If mastitis is suspected, breastfeeding should be stopped - milk may contain bacteria that threaten the health of the baby. You need to express regularly - this will maintain lactation function. Expressed milk from healthy breasts can be given to the baby, but only after pasteurization.

With complications of the disease, it may be necessary to suppress lactation with the help of special drugs. Breastfeeding is resumed only after the full course of treatment and recovery.

Inflammation of the mammary gland in a newborn girl

In a child of any gender after birth, swelling of the mammary glands may be observed during the first 10-12 days. This is completely normal and is due to the fact that his mother's hormones got into his body immediately before childbirth or with milk. This condition is called a sexual crisis. In girls, swelling of the glands is somewhat more common than in boys.

With insufficient hygiene or careless handling, pathogenic microorganisms can penetrate into the mammary gland through the delicate skin of the baby, which will lead to infectious mastitis.

Sometimes inflammation is provoked by the wrong actions of parents during a sexual crisis. In an attempt to eliminate the physiological swelling of the glands, too caring mothers or grandmothers begin to squeeze fluid out of the child’s chest, apply various compresses, ointments. Such actions can cause infection of the skin and give impetus to the inflammatory process.

If the child is calm, the mammary glands are soft, and the skin above them is not reddened, there is no reason for concern. The main symptom of the onset of inflammation of the mammary gland is an increase in body temperature to 38-390C and a deterioration in the condition of the baby:

• constant crying;
• breast rejection;
• restless sleep.

A yellowish liquid with an unpleasant odor may come out of the nipples. At the first signs of an inflammatory process, it is urgent to seek medical help. Delay threatens the rapid development of the disease into a gangrenous form and blood poisoning.

After mastitis suffered in infancy, girls may experience obstruction of the milk ducts in the future, the likelihood of developing mastopathy, inflammation of the mammary gland during lactation, and oncology increases.

Diagnosis of the disease

The clinical picture of acute mastitis does not cause difficulties in diagnosis. To confirm the diagnosis and determine the stage of the disease, the doctor may prescribe a complete blood count and ultrasound.

To determine the resistance of pathogens to antibiotics, a study of milk from the affected gland is carried out. At the purulent stage, a puncture is performed from the infiltrate for bacteriological examination.

Non-lactational and chronic mastitis is similar in symptoms to some other inflammatory breast diseases:

• tuberculosis;
• syphilis;
• actinomycosis.

The diagnosis is established on the basis of the history, histological examination of the puncture and additional blood tests.

Treatment

It is necessary to treat inflammation of the mammary glands. Therapy should be timely and adequate. In the initial stages of mastitis, treatment is carried out with the help of medications and physiotherapy.

conservative methods

A prerequisite for the successful treatment of mastitis is antibiotic therapy. Usually, doctors prescribe antibacterial drugs that are well absorbed in the breast tissue and have a high sensitivity to infectious microorganisms. Medicines are administered intramuscularly or taken in the form of tablets. The course of treatment should be at least 7 days.

Along with antibiotics in severe cases of the disease, the following is prescribed:

• non-steroidal anti-inflammatory drugs (Nimesulide, Diclofenac, Ibuprofen, Meloxicam) to relieve pain and fever;
• injections of Oxytocin to improve breast emptying;
• diuretics (Furosemide, Hydrochlorothiazide) to reduce the amount of fluid in the body;
• hormone-based drugs (Cabergoline, Bromocriptine, Parlodel), which help suppress lactation.

Traumel Gel, a plant-based drug, has proven itself well. It relieves swelling, reduces pain, eliminates congestion in the milk ducts by activating blood circulation in the tissues of the mammary gland.

These or other drugs should be prescribed only by a specialist according to indications. Self-medication and prescribing medicines for mastitis is unacceptable!

Significant assistance in the treatment of the disease can be provided by ultrasound and electrophoresis with Dimexide, Troxevasin. It is recommended to do self-massage of the breast to eliminate milk stagnation in case of blockage of the ducts and express milk every 3-4 hours.

Surgery

With a purulent stage of mastitis, conservative treatment is ineffective. Antibacterial and anti-inflammatory drugs are used in complex therapy after surgery. Usually, in a hospital setting, purulent areas in the mammary gland are opened and thoroughly cleaned to prevent further spread of the pathological process.

The gangrenous stage of mastitis requires the complete removal of the mammary gland or part of it.

After the operation, it is of great importance to eliminate the detoxification of the body and strengthen the immune system with the help of immunomodulatory drugs.

Folk methods

Folk or grandmother's recipes can help eliminate lactostasis and alleviate a woman's condition, but antibiotics cannot be dispensed with even at the initial stage of mastitis. Therefore, if folk remedies are used for inflammation of the mammary gland, then only in combination with traditional methods of treatment.

Any warm compresses for mastitis are contraindicated! Thermal exposure to breast tissue can increase inflammation and even more quickly lead to the formation of an abscess or phlegmon.

To relieve pain in the initial stages, compresses with grated carrots, medicinal herbs, cabbage leaves, and honey compresses are used.

To confirm recovery after the course of treatment, it is necessary to retake blood and milk tests. If no bacteria are found in the milk, and the main indicators of the blood test approach the norm (the level of leukocytes and ESR will decrease), you can resume breastfeeding.

Prevention

Preventive measures to prevent inflammation of the mammary gland in lactating women during lactation should be taken even before childbirth, after the birth of a baby in the maternity hospital and after discharge at home. Prevention includes a few simple rules.

1. Observe personal hygiene. Keeping the skin of the mammary glands clean is the main rule of a nursing woman. It is recommended to wash the breasts with baby soap before and after each feeding, and wash the bra daily. It is advisable to use special absorbent pads.
2. It is advisable to choose underwear specially for nursing women from natural fabrics, perfectly matched in size. A bra made of synthetic materials, squeezing the mammary glands, irritates the skin and can cause blockage of the milk ducts.
3. Constantly moisturize the skin around the nipples, trying to prevent the formation of cracks. Purelan ointment or other lanolin-based moisturizers are recommended. If irritation and cracks appear, treat in a timely manner by applying ointments with dexpanthenol (Bepanthen, Panthenol) or Boro Plus, a natural-based ointment with anti-inflammatory and antibacterial effect, to the nipple area.
4. Observe the regime of the day, spend more time in the fresh air and eat well. Lack of vitamins and minerals, lack of sleep, stress associated with concern about the health of the baby, can significantly undermine the immune system and provoke the development of mastitis under other adverse conditions.
5. Feed the baby on demand, express the remaining milk with a breast pump or manually. When small seals appear in the gland, self-massage the breast.

To prevent non-lactational mastitis, it is necessary to control and treat chronic diseases, avoid chest injuries and hypothermia.

These simple preventive measures will prevent possible problems in the process of breastfeeding and keep the mother and baby healthy. A timely visit to a doctor if there is a suspicion of trouble in the mammary gland and the implementation of all his recommendations is the most reliable way to prevent the development of mastitis in women and its complications.

www.mammologia.ru

2018 Women's Health Blog.

In nulliparous women, mastitis often develops - a purulent inflammation of the mammary gland, in which pathological processes cause unpleasant and sometimes very painful symptoms. Symptoms of mastitis most often occur during breastfeeding, but they can appear even before childbirth, when the expectant mother's breasts begin to swell, preparing for the upcoming lactation.

In some cases, mastitis develops without being associated with pregnancy or breastfeeding (called non-lactating mastitis), and this occurs in women aged 20-60 years. In isolated cases, mastitis is diagnosed in girls who have just been born, which is associated with excessive intake of mother's hormones into the blood.

Inflammation of the mammary gland in women and its treatment is within the competence of mammologists. Among lactating women, the incidence of mastitis is 5-15%, and medical prevention of the disease is often ineffective. The vast majority of patients (85%) are precisely primiparous, since they always have a higher risk of congestive processes in the chest due to the lack of proper feeding and pumping skills. In non-nursing women, the incidence of mastitis is not high (no more than 1% of all mammological pathologies).

Mastitis, or, in the old way, the chest, has a tendency to spread rapidly over vast areas of the mammary gland. Lactational mastitis is always more severe than non-lactational mastitis. This is due to the penetration of pus into the ducts with the flow of milk and the coverage of purulent processes throughout the loose structure of the gland. As a rule, the disease affects only one gland, mainly the right one, but in recent years, doctors have identified many cases of bilateral mastitis. Without treatment, this pathology can cause serious complications, the most formidable of which is sepsis, or blood poisoning.

Why does mastitis develop?

The causative agents of the disease in the vast majority of cases - staphylococcus aureus, streptococcus often - are not susceptible to antibiotics of the first generations. Occasionally, even E. coli affects the tissues of the organ, which can happen after poisoning, intoxication. Inflammation of the mammary gland occurs after the introduction of infection into the tissues, which can occur in various ways:

• through cracked nipples;
• through chafing, sores of the nipples, which were formed due to improper attachment of the child;
• with lymph flow from adjacent foci of infection;
• by hematogenous route from any infectious foci (with reduced immunity).

Mastitis during breastfeeding does not occur in every young mother. There are factors that provoke its development:

• complicated childbirth;
• purulent-septic complications after childbirth from other organs;
• mastopathy;
• large size of the mammary glands;
• flat, inverted nipples;
• scars on the mammary gland;
• decrease in general, local immunity;
• lactostasis (stagnation of milk, impaired venous and lymphatic outflow);
• insufficient emptying of the breast during breastfeeding;
• mechanical injuries of the nipples;
• improper attachment of the child to the breast;
• poor hygiene of the mammary glands;
• use of soiled underwear.

Prenatal mastitis is often associated with pathologies during pregnancy. After childbirth, if the mother's immunity is greatly reduced, the infection can easily spread from the tonsils, urinary tract, lungs, boils, carbuncles, enter the chest and cause inflammation of the mammary gland. Since the gland of lactating women has all the conditions for the existence and active reproduction of the infection, symptoms of mastitis appear after a couple of days.

Of all the above factors, the most common cause of mastitis is lactostasis - stagnation of milk due to its abundant production and insufficient or improper pumping. In the lobule of the gland where the most milk has accumulated, the ducts are clogged with milk "plugs". A woman has seals in her chest, which, however, can resolve after a thorough massage. If you do not pay attention to the problem, purulent mastitis occurs with all the characteristic signs.

Non-lactational mastitis develops without a woman having a breastfed baby. The disease is rare, and its main causes are associated with hormonal disorders, abortion, trauma, compression of the gland, complications of fibrocystic disease, a sharp decrease in immunity, and severe hypothermia. Sometimes such mastitis is a complication of small abscesses or boils in the chest.

Mastitis classification

The division of mastitis, depending on the functioning of the mammary glands, is as follows:

1. Non-lactational mastitis, including fibrocystic mastitis.
2. Lactational (postpartum) mastitis (more than 95% of cases).

The second type of pathology develops only in lactating women. Non-lactating mastitis is associated with other causes and occurs in non-lactating women or in pregnant women.

According to the type of inflammatory process, pathology can exist in several forms. They also represent the stages of mastitis:

1. Serous (acute) mastitis. The initial stage of the pathology, in which inflammation of the breast tissue occurs, the appearance of characteristic signs (high temperature, pain, etc.). It proceeds similarly to the usual lactostasis.
2. Infiltrative mastitis. In one of the lobules of the gland, a seal is formed, causing significant pain.
3. Purulent mastitis. If the first two stages of the pathology are not treated, purulent mastitis causes suppuration of the inflamed area of ​​the mammary gland.
4. Abscessing mastitis. A large purulent focus is localized in the chest.
5. Phlegmonous mastitis. At this stage, there is a spread of purulent phenomena throughout the gland or their transition to a healthy gland.
6. Gangrenous mastitis. There is necrotization of the tissues of the organ, the formation of blood clots in the vessels of the gland.

Usually, purulent mastitis causes localization of abscesses in the following areas:

• near the nipples, or subalveolar mastitis;
• inside the gland, or intramammary mastitis;
• behind the mammary gland, or retromammary mastitis;
• under the skin of the chest.

In addition, acute mastitis and chronic (recurrent) mastitis are distinguished.

How the disease manifests itself

Signs of mastitis vary depending on whether the pathology develops acute or chronic. Symptoms of mastitis in a nursing mother often occur against the background of lactostasis and as its complication, but sometimes they appear suddenly, without prior stagnation of milk. In some cases, mastitis begins only with inflammation of the milk ducts, then it is referred to as galactophoritis. The main symptoms of acute mastitis:

• breast engorgement;
• swelling of the gland;
• the appearance of a painful seal without clear contours;
• redness, hyperthermia of the skin in the affected area;
• inflammation of the nipple and the circle around it;
• increase in body temperature;
• general intoxication (weakness, sweating, headache);
• severe pain in the gland;
• an increase in the size of the entire organ;
• soreness of feeding, pumping;
• sometimes - the appearance of blood in the milk.

With the development of infiltrative mastitis, which occurs in the absence of measures of therapy after 2-3 days, the clinic of the disease intensifies, the general condition continues to deteriorate. As a result of palpation of the breast, it is possible to accurately identify the focus of inflammation (infiltration). Gradually, the pathology acquires a purulent character. Symptoms of mastitis in nursing in this case:

• secretion of milk with pus;
• increased signs of intoxication;
• fever up to 40 degrees;
• growth of infiltrate;
• the appearance of fluctuations (fluctuations of the skin due to the presence of liquid pus);
• the presence of extensive cavities with pus (phlegmonous mastitis);
• shine, hyperemia of the skin;
• the appearance of bluish spots;
• enlarged axillary lymph nodes.

If gangrenous mastitis develops, in addition to purulent fusion and extensive tissue necrosis, inflammation spreads to the chest. In this case, the pathology may be complicated by sepsis.

Signs of chronic mastitis occur as a result of improper treatment of acute mastitis. Gradually, small abscesses form in the mammary gland, the tissues around them thicken and become hard. Slow inflammation causes the formation of fibrous ridges around purulent cavities (encapsulation). The body temperature of a woman is subfebrile or normal, the lymph nodes are often enlarged. The gland itself is moderately painful, the skin is slightly reddened, a serous fluid is released from the nipple, sometimes with blood. With non-lactational mastitis, the symptoms are similar to those with chronic mastitis, proceeding with mild severity.

Mastitis: is the danger great?

The danger of pathology exists already at the stage of purulent processes, when a cavity filled with pus forms in the chest. It is impossible to cure her with the methods of conservative medicine, so the woman has to undergo an operation to remove pus, stopping feeding the baby. Gangrenous mastitis is very difficult, irrevocably spoiling the shape of the breast and often complicated by general blood poisoning.

The consequences of mastitis are possible even after a successful operation. Some time after discharge, a woman develops a milk fistula, which can resolve or fester again. Also, against the background of reduced immunity, suppuration of the postoperative suture often occurs, or a new exacerbation of mastitis. In addition, any operation causes aesthetic damage to the mammary gland, sometimes significant. Long-term complications of mastitis can be fibrocystic or nodular mastopathy and even breast cancer.

Examination for mastitis

Usually, acute mastitis does not raise doubts in the diagnosis already when examined by a mammologist and palpation of the affected area of ​​\u200b\u200bthe chest, lymph nodes. To clarify the diagnosis and differentiate it from some forms of cancer, ultrasound is prescribed, reflecting inflammation in the gland:

• expansion of the ducts;
• increasing the thickness of the skin, a layer of fiber;
• decreased tissue echogenicity;
• the presence of a zone with greatly reduced echogenicity (inflammatory infiltrate);
• the presence of abscesses, necrotic tissues.

Sometimes, if the ultrasound picture does not give an accurate picture of the nature of the disease, an x-ray examination (mammography) may be required. A biopsy of the abscess or infiltrate is possible using fine needle aspiration. If treatment is ineffective, antibiotics for mastitis are selected after bakposev discharge from the mammary gland and determine the sensitivity of the pathogen to drugs. Additionally, the doctor may prescribe the following examinations:

• clinical analysis of urine, blood;
• cytology of milk from a diseased gland.

If it is not possible to visit a mammologist, you should contact the clinic for a surgeon or gynecologist.

Features of the treatment of mastitis

If the prevention of mastitis was ineffective, treatment of the pathology should be started as early as possible. This will help prevent purulent processes, cancel the need for surgery. An important non-drug measure of therapy is the correct expression of milk every 3 hours. Since this manipulation is very painful, it is often performed after a novocaine blockade. If within a day the desired effect does not occur, antibiotic therapy is prescribed. Antibiotics for mastitis are administered intramuscularly, and sometimes additionally - in the area of ​​inflammation. Use penicillins, more often - cephalosporins. If the purulent focus continues to increase, a surgical operation is performed.
Other treatments that are used for mastitis (duration 7-15 days):

1. Desensitizing and antihistamine therapy.
2. Drug suppression of lactation (drugs are used to inhibit the production of prolactin). Such treatment will be required for phlegmonous mastitis and necrosis, as well as for severe disease in combination with various complications.
3. Taking vitamins (especially with mastitis, ascorbic acid, a group of vitamins B, is indicated).
4. Reception of antispasmodics, painkillers.
5. Treatment of intoxication (infusion of glucose, electrolytes).
6. Physiotherapeutic methods.
7. Application of Vishnevsky ointment (bandages, compresses).

Feeding for the period of therapy will have to be stopped due to the presence of infection in the milk, as well as decay products of bacteria and leukocytes. The intake of such milk can provoke digestive disorders in the baby and the development of intestinal dysbiosis.

Operation for mastitis

Within two days, the doctor decides on the surgical intervention. Indications for surgery:

• lack of positive dynamics;
• symptom progression.

Breast surgery for mastitis is performed under general anesthesia. An important task of the doctor is not only the complete extraction of the purulent focus, but also the maximum preservation of the aesthetic appeal of the gland. The abscess is opened, bridges, pockets, all necrotic areas are removed, the cavity is drained. If there is an infiltrate, it is also removed completely. With abscessing mastitis, it is important to excise each purulent focus, so several incisions in the mammary gland are performed.

After the operation, the woman expresses her milk to prevent stagnation. Wounds are drained, washed with antiseptics, which will help them heal faster and with less cosmetic consequences. The sutures are removed 7-10 days after the operation. In the early rehabilitation period, treatment with antibiotics, general strengthening drugs, vitamins, immunomodulators, UV, UHF, microcurrents, and magnetotherapy are indicated.

Treatment of mastitis at home is allowed only at the stage of the serous type of pathology, before the formation of abscesses. Since it is quite difficult to determine the type of disease on your own, mastitis is treated with folk methods after consulting a doctor. Such popular recipes are popular:

1. Compresses with mint leaves. For resorption of edema and seals with mastitis, fresh mint leaves are taken, crushed a little and crushed until the juice is released, applied to the chest. From above, the mammary gland is wrapped with gauze, a cloth. The compress is kept for 2 hours, after which it is removed, at least 2 procedures are performed per day. If there were no fresh leaves available, you can steam the dried ones and repeat the procedure in the same way. In addition to mint, leaves of cabbage, alder, coltsfoot have an excellent resolving effect.
2. Compresses with chaga. A piece of chaga mushroom should be well steamed in boiling water, cool. Wrap it with a bandage, attach it to the mammary gland, cover it with parchment on top (without cellophane). Leave the compress on all night, thus being treated for 7 days.
3. Honey onion compresses. Bake an onion in the oven. Grind the onion into gruel, add a spoonful of honey. Run a compress on the chest from this mass, secure with a rag, leave overnight. The course of treatment is 5 days.

Prevention of mastitis

Every woman after childbirth, especially a primipara, should remember that only properly organized prevention will save her from such an unpleasant disease as mastitis. Of course, not everyone can learn how to correctly attach the baby to the breast and optimally set the feeding regimen. But nowadays in any maternity hospital and antenatal clinic there are breastfeeding specialists who will gladly initiate a woman into all the mysteries of lactation. Prevention measures for mastitis are as follows:

• feeding on demand;
• pumping milk if the child for some reason "delays" the feeding process;
• no restrictions on the duration of feeding;
• timely treatment of cracks, wounds on the chest and nipples;
• observance of hygiene of a breast, all body;
• wiping the mammary glands only with a soft towel;
• do not wash your breasts with cold water;
• treatment of nipples between feedings with Bepanten ointments, sea buckthorn oil;
• preventing the baby from seizing the nipple without the areola;
• carrying out a light massage with the formation of seals in the chest;
• performing special physical exercises for the postpartum period.

Usually, even in the maternity hospital, a woman is told how to deal with lactostasis and take care of the mammary glands during lactation. Compliance with all these rules will help prevent inflammation of the glands and, possibly, severe surgery.

Mastitis, or, as it is also defined, the breast, is a disease in which the mammary gland is exposed to inflammation. Mastitis, the symptoms of which can be observed in women aged 15-45 years, is in the vast majority of cases associated with breastfeeding, but the possibility of the appearance of this disease immediately before childbirth or without any connection with them and with pregnancy is not excluded.

general description

Mastitis is noted in about 70% of cases in women who have given birth for the first time, in 27% - in women who have given birth for the second time, and, accordingly, in 3% of cases - in women with multiple births. It is noteworthy that mastitis can also develop not only in women without a corresponding connection with pregnancy, but also in girls, and even in men.

Mastitis, not associated with pregnancy and breastfeeding, is defined as non-lactational mastitis, it appears mainly due to trauma to the mammary gland, is not excluded as a cause and a variant of the development of this disease as a result of the relevance of hormonal disorders for the female body.

Causes of mastitis

As the main reason for the development of mastitis, the bacteria enter directly into the breast tissue. This can happen through cracks in the nipples, which in this case act as an open gate for penetration into the specified infection environment, as well as through blood, which occurs in the presence of chronic infectious foci in the body. In the latter case, such foci include pyelonephritis, chronic tonsillitis and other diseases.

It should be noted that in a normal state of health, the entry of a certain amount of bacteria into the mammary gland leads to their corresponding destruction, carried out by the immune system. Meanwhile, the vast majority of cases indicate a weakening of the female body after childbirth, respectively, the immune system ceases to properly fight infections.

As an important point contributing to the development of the disease we are considering, lactostasis should be singled out, in which stagnation occurs in the ducts of the milk glands, which occurs due to insufficient decantation of milk, incomplete decantation, or due to rare feedings. Stagnation of milk in the ducts provides a favorable environment for the process of reproduction of bacteria, because milk as a whole has a mass of nutrients.

Mastitis: types

There are the following main types of mastitis:

• lactational mastitis (postpartum mastitis) - the most common variant of the disease (about 85%), associated with breastfeeding;
• non-lactational mastitis (fibrocystic mastitis) - accordingly, it occurs due to the influence of causes not related to breastfeeding;
• mastitis (breast) of newborns - manifests itself in the form of breast engorgement in a newborn baby, and gender is not a determining factor in this case, respectively, the disease can develop in both boys and girls. The reason for its development is the transition from the maternal blood of lactogenic hormones (that is, hormones that stimulate lactation).

Based on the characteristics of the current inflammatory process, the following types of mastitis are determined:

• acute lactostasis, in which there is no milk secretion;
• serous mastitis;
• acute infiltrative mastitis;
• destructive mastitis;
• chronic mastitis (in purulent or non-purulent form).

In accordance with the specific area of ​​localization, the following types of mastitis are distinguished:

• subcutaneous mastitis;
• subareolar mastitis (that is, concentrated in the area under the areola);
• intramammary mastitis (focused directly on the mammary gland);
• retromammary mastitis (focused outside the mammary gland).

Mastitis and lactostasis

One of the reasons that provokes lactostasis is the "irregularity" of the shape of the nipples (which is important with inverted or flat nipples), which makes it difficult for the baby to suckle the breast, and also leads to incomplete emptying when feeding the mammary glands, which, in turn, leads to lactostasis .

As we have already noted, lactostasis in general implies stagnation in the ducts of the milk glands due to insufficient expression. As a result of this condition, the mammary gland becomes painful, focal seals appear in it, disappearing under the influence of massage. From the painful area of ​​​​the gland, milk flows unevenly. Mostly without a combination with mastitis, lactostasis is not accompanied by a temperature, however, if lactostasis is not eliminated within a few days, then it will inevitably move to mastitis. Mastitis in this case is accompanied by a temperature of up to 39 degrees.

Accordingly, the basis for the development of mastitis is precisely lactostasis, which acts as the root cause. In addition to these factors, lactostasis is also caused by a number of other options:

• improper attachment of the baby to the breast;
• the process of feeding the baby when taking only one position;
• giving the baby a nipple, which leads to subsequent tactics on his part as a "passive smooch";
• the use of a special lining on the nipple when feeding the baby;
• sleep on the stomach;
• stress;
• tight clothing, bras;
• restrictions in the frequency of feeding the baby, temporary restrictions in this process, as a result of which the breast is not emptied properly;
• excessive physical activity, spasmodic ducts of the glands;
• bruises and injuries of the chest;
• feeding the baby without warming up after suffering hypothermia;
• sudden transition to artificial feeding of the child.

Mastitis: symptoms

The clinic of manifestations of mastitis today has the following features:

• late onset, noted after a period of about 1 month from the moment of birth;
• the frequent appearance of subclinical and erased forms of the disease, the symptoms of which are not evidence of the true state of affairs regarding the process in question;
• the predominant variant of the appearance of infiltrative-purulent mastitis in patients;
• the duration of the course of purulent mastitis.

The symptomatology of mastitis depends on its specific form, below we will consider their main options.

Serous mastitis. The symptoms of the disease, as, in fact, its course, are characterized by the severity of the manifestation, the onset of this mastitis falls on a period of 2 to 4 weeks from the moment of birth. There is an increase in temperature (up to 39 degrees), chills. There are also symptoms associated with intoxication in the form of weakness, headache, general weakness. First, patients experience heaviness in the mammary gland, and then pain, milk stagnation occurs.

At the same time, there is a certain increase in the volume of the mammary gland, the skin undergoes redness (hyperemia). When trying to express milk, severe pain is felt, the result does not bring relief. The lack of adequate measures of therapy, as well as the progression of inflammation, leads to the fact that serous mastitis develops into infiltrative mastitis.

Infiltrative mastitis. In this case, the chill experienced by the patient is strong enough, pronounced tension and pain are felt in the mammary gland. Also relevant are symptoms in the form of loss of appetite, insomnia, headache and general weakness. There is also an increase in the mammary gland, redness of the skin. In addition, patients experience pain in the axillary lymph nodes, which is combined with the pain of their palpation (palpation). The untimely treatment of this form of the disease, as well as the lack of effectiveness in it, leads to the fact that the inflammation becomes purulent, which, in turn, ensures the transition to the corresponding, purulent form.

Purulent mastitis. Here, the patient's condition worsens significantly. Appetite decreases, weakness increases, problems with sleep appear. The temperature rise is mostly kept within 39 degrees. The chill persists, the skin becomes pale, sweating increases. In the mammary gland, tension and pain are still felt, its size is increased, redness has a pronounced manifestation, the skin is swollen. Expression of milk is greatly complicated, often in the resulting small portions of it you can find pus.

Mastitis abscessing. As the predominant options, an abscess of the areola or furunculosis is distinguished, retro- and intramammary abscesses in the form of purulent cavities are somewhat less common.

Phlegmonous mastitis. In this case, the inflammatory process captures a larger area of ​​the mammary gland, followed by melting of its tissues and switching to the surrounding tissue and skin. The patient's condition is generally defined as severe, the temperature is about 40 degrees.

The chill persists, intoxication has a pronounced character of its manifestations. There is a sharp increase in the volume of the mammary gland, swelling of her skin. In addition to reddening of the skin, cyanosis is also noted in some areas of the affected gland. Feeling (palpation) indicates its pastosity (swelling), as well as pronounced pain. With this form of mastitis, the possibility of developing septic shock is not excluded.

Gangrenous mastitis. The course of the disease is largely complicated, intoxication has an extremely pronounced nature of manifestations. Necrosis of the mammary gland develops (that is, it necrosis occurs). The patient's condition is generally severe, the skin is pale, there is no appetite, insomnia appears.

The temperature is about 40 degrees, there is an increase in the pulse (up to 120 beats / min.). The affected gland is enlarged, its swelling and soreness are noted. Above it, the skin may be pale green or purple-cyanotic, some places have areas of necrosis and blisters. There is no milk, the nipple is retracted. Enlargement and soreness also occur in the region of regional lymph nodes, which is detected by palpation.

Diagnosis

The pronounced manifestations of the symptoms of the disease we are considering do not lead to any difficulties in making a diagnosis, which is based both on the general complaints of the patient and on an objective examination of her mammary glands.

It should be noted that with an underestimation of the symptoms characteristic of a purulent process, as well as with an overestimation of factors in the form of skin hyperemia and the absence of fluctuation by a doctor, it can lead to long-term treatment of a purulent form of mastitis, which in the end will simply be unjustified. Irrational antibiotic therapy in the case of abscessing mastitis or infiltrative-abscessing mastitis leads to a serious threat of the development of the disease in its erased form, in which the symptoms do not determine the actual condition of the patient and the severity relevant to the inflammatory process.

In such patients, the temperature is initially elevated, reddening of the skin and its swelling are often noted, naturally, within the framework of the mammary gland. These signs are eliminated by prescribing antibiotics. As a result, the temperature drops to normal levels during the daytime, with a possible slight increase in the evening. Signs of a local character, indicating purulent inflammation, are absent or very weakly expressed. Painful sensations in the mammary gland are moderate. Palpation reveals an infiltrate with the same size or with the size gradually increasing.

Infiltrative-abscessing mastitis, noted in more than half of the cases, has an infiltrate consisting of a large number of purulent cavities of small sizes, however, when used as a diagnostic method of infiltrate puncture, pus can be obtained extremely rarely. If, however, the puncture method is applied to the erased form, then it is already expedient to assert its value as a diagnostic method.

As additional diagnostic methods, a blood test is used, as well as echography of the glands.

Mastitis treatment

The treatment of the disease is determined based on the characteristics of its course, form and other factors in a strictly individual order, and its measures are focused primarily on reducing the growth of the number of bacteria while simultaneously affecting the inflammatory process in order to reduce it. In addition, of course, therapy involves the selection of appropriate measures aimed at pain relief.

With non-purulent forms of mastitis, conservative methods of treatment are applicable. Antibiotics are used as the main drugs, the sensitivity of bacteria is the basis for their choice. Basically, these antibiotics belong to the penicillin group, to cephalosporins, etc. They are applicable internally, intravenously or intramuscularly. Anesthetics are used to relieve pain.

Expression of the patient's milk should be done at intervals of three hours and for both mammary glands, this is done to avoid stagnation of milk. The acceleration of the healing process is facilitated by a decrease in milk production or the complete suppression of this process through the prescription of appropriate drugs by a doctor. After recovery, lactation can be resumed.

As for the treatment of purulent mastitis, it is carried out exclusively through surgical intervention. As an addition to the treatment, physiotherapeutic procedures in the form of UHF and laser therapy, vitamin therapy, antianemic therapy and desensitizing therapy are used.

If mastitis is suspected, it is necessary to contact the attending gynecologist and mammologist.

Inflammation of the mammary gland is most common in women, less often pathology occurs in men. The progression of the disease falls on the period of sexual activity. In women, the inflammatory process occurs at the age of 16–35 years. The risk group includes women during lactation, as well as those who have this disease is inherited.

Mastitis or inflammation of the mammary gland is a predominant female ailment. It is an inflammatory process in the tissues of the mammary gland. Pathology is accompanied by severe pain in this area, as well as hardening of the skin on the chest or near the nipple. There may be reddening of the skin and an increase in body temperature, which is inherent in any inflammatory process.

In women, the disease can manifest itself from the moment of puberty to menopause. A woman is exposed to an illness during the period of hormonal activity of the body, which occurs at the age of up to 35 years. Less commonly, pathology occurs in mature men. There are many reasons for the development of the disease in both sexes.

The reasons

Quite often, inflammation of the mammary glands occurs during breastfeeding. In this case it may be:

• the consequences of milk stagnation due to lack of feeding or due to the baby's capabilities;
• violations of the feeding process, improper attachment to the breast;
• duct injury;
• anatomical pathology of the nipple;
• entry of microorganisms through microtrauma associated with feeding;
• infections that enter from other body systems through the bloodstream;
• hypothermia of the chest;
• low immunity after childbirth;
• anatomical features of the breast, its size.

Often, the inflammatory process develops in women who do not deal with lactation, who do not have children. The cause of the development of the disease lies in other factors:

In men, this condition develops quite rarely, but there are reasons for this:

• metabolic disorders;
• pathologies of the endocrine system that lead to hormonal disorders;
• diseases of the genitourinary system;
• tumor processes;
• excessive production of estrogen against the background of adrenal dysfunction;
• mechanical injury.

More often, pathology occurs due to hormonal imbalance, and the following factors may be to blame:

• abuse of alcoholic beverages, especially beer;
• uncontrolled intake of drugs (tranquilizers and drugs that lower blood pressure);
• the use of steroid drugs and anabolics;
• diseases of the digestive tract, causing false symptoms of inflammation of the glands.

Forms of the disease

In addition to the fact that mastitis in a woman is divided into types according to the lactation period, there are acute and chronic forms of the disease.

Mastitis can develop not only in men and women, but even in newborns, the reason for this is congenital pathologies and hormonal disorders. The chronic form is more common in women who have reached the climacteric barrier.

In addition, mastitis is divided into types according to the clinical course of the disease.

Serous

This type of inflammatory process has nothing to do with soft tissue infection, but is characterized by the accumulation of serous exudate in the cavity of the gland. Treatment at the initial stage is very important and prevents possible complications.

Spicy

It develops when an infection enters the nipple area and rapidly spreads over the entire breast area.

Chronic

This type of inflammation develops due to lack of or improper treatment. This is especially true for acute infectious mastitis. Antibacterial therapy does not always have the expected effect, and not everyone undergoes a re-examination. So the acute form smoothly turns into chronic mastitis.

phlegmatic

An advanced type of mastitis leads to a deterioration in the general condition and serious consequences of poisoning the body. It is very difficult to diagnose and treat this type.

gland abscess

This is the result of serous or acute mastitis, which is characterized by the accumulation of exudate in the cavity of the gland and leads to the production of a purulent process. In difficult cases, fluid is released from the nipple, which brings a lot of inconvenience and pain.

Gangrene

This is an advanced stage of the inflammatory process, in which the soft tissues of the gland begin to die off and conventional conservative therapy is then powerless.

Symptoms

It is impossible to accurately diagnose mastitis by symptoms, but the first signs should serve as a signal to see a doctor. Inflammation of the breast never goes away without symptoms. The first changes in the structure of mammary gland tissues are manifested by discomfort and pain.

The skin turns red, and the upper layer of the skin thickens, after which the structure of the nipple changes. Very often, the inflammatory process is accompanied by inflamed lymph nodes under the armpits and in the chest area.

Local hyperthermia is replaced by an increase in body temperature. Severe fever and chills are possible. With the progression of the disease, all signs of intoxication of the body appear.

When breastfeeding, the pain with mastitis becomes unbearable, especially in the nipple area. Symptoms of mastitis during lactation appear 2-3 days after the stagnation of milk in the glands.

Without treatment, the symptoms become more pronounced, the pain intensifies, and the body temperature can reach 40 degrees.

Diagnostics

Only a mammologist can accurately establish the diagnosis. With the appearance of the first signs, it is necessary to consult a specialist to confirm or refute suspicions regarding the inflammatory process in the mammary glands.

Examination of the mammary glands begins with an external examination and palpation. So you can assess the condition of the skin on the chest, in the nipple area, as well as identify seals in the structure of the gland. It is also important to treat not only the signs, but also the cause itself.

If deviations are found, additional examinations are prescribed after. An accurate way to determine inflammation or another undesirable process is an ultrasound and x-ray examination of the milk ducts. Based on the results, it is possible to establish the stage of development of the disease, and after that the type of mastitis. And also with the help of pictures, the doctor can see other deviations and the presence of seals and neoplasms. If the diagnosis is confirmed, the treatment will be very different.

If formations are found on the pictures, additional examinations are needed:

The difficulty in diagnosing mastitis lies in the rather difficult difference between an abscess in inflammation and a malignant formation.

Treatment

You can treat and cure mastitis by contacting a doctor in time. At the initial stage, after carrying out all the necessary examinations and analyzes, a comprehensive treatment is carried out aimed at eliminating the causes of mastitis and the symptoms of the manifestation of the disease.

Therapy should take place under the supervision of a doctor with the implementation of all prescriptions. If the treatment does not go according to all the rules, unforeseen complications may develop, and mastitis can become chronic. To remove only the symptoms, then this is not a cure, but a temporary measure.

If mastitis is observed in women in the postpartum period due to milk stagnation, it is important to prevent this process and express milk in a timely manner, then it is not necessary to treat the disease.

A woman's body cannot know how much milk a child needs, so it produces its own amount, which is often more than necessary. It is necessary to carry out the pumping procedure regularly every three hours, regardless of the feeding of the child.

In an infectious inflammatory process, antibiotic therapy is prescribed. Against the background of taking the drugs, the symptoms will recede after a week of therapy, but treatment cannot be stopped. It is necessary to take a two-week course to completely get rid of pathogenic bacteria in the body. After all, it is untreated mastitis that causes serious disorders, not to mention the transition of the inflammatory process into a chronic form.

In addition to medicines, it is recommended to use time-tested recipes of traditional medicine. Treat inflammation with herbs and infusions on them. To suppress symptoms such as pain, redness and swelling, an infusion of medicinal herbs, compresses from freshly squeezed aloe juice and Kalanchoe are suitable. You can use cabbage leaves and plantain leaves externally. It is not at all dangerous to treat with folk recipes, it will not be worse for sure.

Treatment includes taking vitamins and immunostimulating drugs so that the body can fight the disease itself.

Self-treatment of mastitis is dangerous with consequences, so all actions must be agreed with the doctor.