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1、MastitisJoeBreuner,M.D.ThankstoDougTrotter,whogavethistalk18monthsagoCasePresentationHealthy25year-oldwoman,G2P2,witha6week-oldinfantInfantisfullybreast-fedPatientisfatiguedduetocaringfor2youngchildrenHusbandisBoeingengineer,stressedbecauseoflikelyupcominglayoffAt6weekvisit,shereports2
2、episodesofmoderatelypainfulswellinginupperinnerquadrantofRbreast;itoccurredonceinLbreastItusuallyresolves,butshewantstoknowwhyithappens,andwhattodoCasePresentationExam:AfebrileLookstiredbutotherwisewellNormalnippleandbreast;nolumpsorinduratedareasNoskinchangesorlymphadenopathyCasePrese
3、ntationExam:AfebrileLookstiredbutotherwisewellNormalnippleandbreast;nolumpsorinduratedareasNoskinchangesorlymphadenopathyDx:Milkstasisor“pluggedduct”CasePresentationRiskfactorsformilkstasis:Fatigue,stressInfrequentfeedingIncompleteemptyingofbreastIll-fittingbraPumps,shieldsPriorbreastt
4、raumaorinfectionMilkstasisTreatmentformilkstasis:HeatapplicationMassagetowardnippleFrequent,relaxednursingChangepositiontopromoteemptyingAvoidpumps,shieldsMilkstasisPtcallsyouSundayafternoon,3PM,now7weekspostpartumHadrecurrentswellingofupperinnerquadrantRbreastyesterday,butdidn’tresolv
5、eNow2hrsoffever,chills,increasedtendernessCasePresentationPtcallsyouSundayafternoon,3PM,now7weekspostpartumHadrecurrentswellingofupperinnerquadrantRbreastyesterday,butdidn’tresolveNow2hrsoffever,chills,increasedtendernessDx:AcutemastitisCasePresentationIncidence:2-3%oflactatingwomenMas
6、titisIncidence:2-3%oflactatingwomenMorecommonat2-6weekspost-partum,butcanoccuratanytimeMastitisIncidence:2-3%oflactatingwomenMorecommonat2-6weekspost-partum,butcanoccuratanytimeMorecommoninprimiparas,butprobablyduetobiasMastitisIncidence:2-3%oflactatingwomenMorecommonat2-6weekspost-par
7、tum,butcanoccuratanytimeMorecommoninprimiparas,butprobablyduetobiasRiskfactors:milkstasis,age>30,stress,fatigue,professionalemploymentofmotherorfatherMastitisNormalbreastarchitectureMastitis1970Series:71casesofacutelactationalmastitisPeakincidenceat2-3weekspostpartumNoinfantsweaned;n
