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