Non-lactational mastitis: symptoms and treatment
Non-lactational mastitis is an inflammation of the mammary gland that develops in a woman outside the period of breastfeeding. Most often, mastitis manifests itself against the background of hormonal changes in the body: during puberty or menopause. Hormonal imbalance contributes to the deterioration of the immune system, the body's natural defenses are weakened, which allows microbes to more easily manifest their pathological activity.
According to statistics, non-lactational mastitis accounts for about 5% of all breast inflammations. The age of affected women varies widely, and a similar diagnosis is made to 15-year-old adolescents and 60-year-old elderly women.
If we compare lactational and non-lactational mastitis, then the second has a less violent course, rarely causes generalized complications. However, the danger of the disease becoming chronic is significantly higher.
Content:
- Causes of non-lactational mastitis
- Symptoms of non-lactational mastitis
- Types of non-lactational mastitis
- Diagnosis of non-lactational mastitis
- Treatment of non-lactational mastitis
- Prevention of non-lactational mastitis
Causes of non-lactational mastitis
The reasons that can lead to the development of non-lactational mastitis are as follows:
- Diseases of the reproductive system or disorders in the hypothalamus and pituitary gland, which leads to hormonal imbalances in the body.
- A sharp decrease in the level of estrogen in a woman's body against the background of menopause.
- The period of puberty, which is accompanied by hormonal imbalances in the body.
- Disorders in the immune system, which contributes to the weakening of the defenses. The transferred viral and bacterial infections, physical stress, sudden hypothermia, stress, etc., weaken the immune system.
- Chronic foci of infection in the body. The danger is represented by diseases such as caries of tooth enamel, tonsillitis, pyelonephritis, genital infections, dermatological diseases of a bacterial nature.
- Metabolic disorders such as diabetes mellitus, hypothyroidism, hyperthyroidism, obesity, etc.
- Breast trauma. The greatest danger is chest compression.
- Thermal damage to the chest, for example, when applying a heating pad.
- Complications after surgery on the chest. Moreover, any medical manipulations on the mammary gland are dangerous, including the installation of implants, removal of cysts and fibrous growths.
In 90% of cases, non-lactational mastitis is caused by Staphylococcus aureus. Other representatives of the bacterial flora provoke inflammation much less frequently. Epidermal staphylococci, Proteus, Escherichia coli can be sown.
The causative agent of the infection enters the mammary gland in three ways:
- Hematogenous (with blood flow);
- By the lymphogenous route (through the lymphatic vessels);
- Through damage to the skin in the breast or nipple area.
The hematogenous and lymphogenous pathway of infection leads to the fact that the inflammation is localized around the vessels. When the microorganism penetrates the skin, intracanalicular inflammation is observed.
First, a serous exudate forms inside, which eventually becomes purulent.
Chronic non-lactational mastitis develops against the background of untreated acute non-lactational mastitis. Most often, the woman herself is to blame, who, after the onset of improvement, stops therapy, or does not seek medical help at all, self-medicating.
Symptoms of non-lactational mastitis
The clinical picture of non-lactational mastitis is not as vivid as with inflammation of the mammary gland during breastfeeding. This often complicates self-diagnosis and prevents timely initiation of treatment. Therefore, if a woman knows the symptoms of non-lactational mastitis, she will be able to seek medical help in time.
Symptoms of the initial stage of non-lactational mastitis (non-purulent serous form):
- The appearance of mild pain in the mammary gland.
- Normal body temperature, or its rise to subfebrile levels.
- The appearance of a seal in the mammary gland. Most often it is located in the areola area.
- Slight redness of the skin in the area of inflammation is possible.
Symptoms of the infiltrative stage of non-lactational mastitis:
- The body temperature rises and can reach 38.5 ° C.
- Signs of body intoxication appear.
- Chest pains become more intense, becoming pulling in nature.
- The seal is well palpated, which, when touched, gives off pain.
- The skin over the lump turns red, the chest may swell. Sometimes the mammary gland becomes hot to the touch.
- The chest becomes larger.
Symptoms of the purulent stage of mastitis:
- Body temperature rises to high levels. It can reach febrile values of 39-40 ° C.
- Signs of intoxication are pronounced. A woman experiences general weakness, she is worried about a headache, chills join, nausea and vomiting may occur, appetite disappears.
- The chest pain intensifies, has a pulsating character.
- The swelling of the skin becomes pronounced, the surface of the chest becomes bright red.
- Axillary lymph nodes swell and hurt.
Chronic mastitis symptoms:
- The disease often recurs, it can occur 3-4 times a year.
- The mammary gland will be deformed, it is possible that the skin will be drawn in the affected area.
- Purulent fistulas may form on the surface of the chest.
- Pus during an exacerbation of the disease can be released from the nipples.
Types of non-lactational mastitis
The following types of non-lactational mastitis are distinguished, each of which has characteristic symptoms:
- Absolute mastitis. One or more small abscesses that are filled with pus form in the breast.
- Infiltrative abscessing mastitis. The course of the disease is more severe. Abscesses are formed in the infiltrate, have a different size and shape.
- Phlegmonous mastitis. The mammary gland swells greatly, a retracted area appears on it. The skin turns red in places and bluish in places. Nipple retraction possible. The area of the chest lesion is quite extensive.
- Gangrenous mastitis. Breast tissue and blood vessels are severely affected. The process is accompanied by the active formation of blood clots. The impossibility of normal blood supply to the breast leads to the formation of areas of necrosis. Zones of dead tissue appear on the surface, bubbles filled with ichor. The entire mammary gland is involved in the pathological process. The patient's condition is very serious, confusion, a decrease in blood pressure is not excluded. Against the background of gangrene formed, the risk of septic blood poisoning increases. This poses a direct threat not only to health, but also to the life of a woman.
Diagnosis of non-lactational mastitis
If you suspect inflammation of the mammary gland, you should contact either a mammologist or a gynecologist. The doctor will listen to the patient's complaints and examine the breast.
To confirm the diagnosis, the following tests will be required:
- Delivery of a general blood test. Inflammation will be indicated by an acceleration of ESR, an increase in the level of leukocytes.
- Delivery of a general urine test.
- If there is purulent inflammation, then a puncture is performed and the collected material is sent for bacteriological examination.
- Ultrasound of the breast.
The chronic course of the disease often requires mammography to clarify the diagnosis. High-quality diagnosis of non-lactational mastitis is a prerequisite, since there is a risk of neglecting a disease such as breast cancer.
Treatment of non-lactational mastitis
With a timely visit to the doctor, the treatment of non-lactational mastitis is not difficult. It is important to start implementing therapeutic measures as early as 3-4 days after the manifestation of the disease. If the inflammation turns into a purulent form, then often it is necessary to resort to surgery.
If the disease is diagnosed at an early stage, then the doctor prescribes anti-inflammatory drugs, the imposition of semi-alcohol compresses, Vishnevsky ointment or Ichthyol ointment.
When a woman has already formed an infiltrate, then one cannot do without taking antibiotics. Prescribe drugs with a wide spectrum of action: Amoxicillin, Amoxiclav, Cephalexin, Cefuroxime, etc. When the bacterial flora is resistant to them, it is possible to use Ciprofloxacin (fluoroquinolone group) or Gentamicin (aminoglycoside group). If there is no pus in the chest, then oral medication is possible. In the destructive form of mastitis, antibiotics are administered either intramuscularly or intravenously.
To help the body cope with the infection faster and prevent the development of complications, the following points must be observed:
- Appointment of probiotics (Linex, Hilak Forte, Bifiform, etc.).
- Prescription of antifungal drugs (Fluconazole, Candide, etc.).
- Prescription of antihistamines (Tavegil, Zodak, Loratadin, etc.).
- Appointment of detoxification solutions (Gemodez, Reopolyglyukin, etc.).
- Appointment of immunostimulants (Globulins, Absorbed toxoid).
- To increase the body's resistance, B vitamins, ascorbic acid are prescribed.
If the woman's condition improves, then a day after the start of treatment, physiological procedures can be carried out, for example, UHF therapy. This promotes the early resorption of the infiltrate and the restoration of breast tissue.
The affected breast must be provided with maximum rest. Avoid wearing a tight bra or a pinching bandage. The chest should be supported, but not squeezed.
When conservative treatment does not bring the desired effect, surgical intervention is necessary. The purulent cavity is opened, the tissues are cleaned of pathological contents, the wound is sanitized, the existing necrotic areas are removed and drainage is installed. Drip washing of the wound is carried out for 5-12 days, which minimizes the risks of recurrence of the disease. The operation is performed under general anesthesia. In order to return the breast to its previous shape, it is possible to install an implant in the future.
After the performed surgical intervention, drug therapy is carried out. It allows you to quickly remove toxins from the patient's body. Antibiotics are prescribed without fail. They are administered either intravenously or intramuscularly. The drugs of choice in this case are the first or second generation cephalosporins.
Prevention of non-lactational mastitis
Non-lactational mastitis is not a very common disease among the female population.
Nevertheless, it is periodically diagnosed, so it will be useful to familiarize yourself with the basic recommendations aimed at preventing its development:
- Diseases of the reproductive system must be treated in time. For any problems with hormonal levels, you should contact a specialist.
- During and after menopause, a woman must be examined by a gynecologist.
- The foci of chronic infection must be properly sanitized.
- The mammary gland should be treated with care, trying to protect it from various kinds of injuries.
- Choose a bra by size. It is best to give preference to linen made from natural materials.
- It is important to keep your breasts clean by washing them daily with warm water and soap.
- Maintaining the state of the immune system at the proper level allows maintaining a healthy lifestyle, proper nutrition, and adequate rest.
It should be remembered that any disease is easier to cure in the early stages. This statement is quite valid for non-lactational mastitis.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
