Catarrhal mastitis
Catarrhal mastitis is an inflammatory reaction in the ducts and alveoli of the mammary glands. The disease is manifested by inflammation of the internal mucous membranes, as well as redness, swelling and swelling of the gland, the appearance of exudate. The accumulated exudate can be serous, mucous, or purulent.
"Qatar" translated from Latin means "runoff" or "flow", which characterizes the process of inflammation in the mammary gland. Modern medical literature considers this term as outdated, however, it persists in the names of some human diseases. Therefore, you can find such a diagnosis as "catarrhal rhinitis" or "catarrhal mastitis". It is about the latter that will be discussed later.
Content:
- The reasons for the development of catarrhal mastitis
- Catarrhal mastitis symptoms
- Diagnosis of catarrhal mastitis
- Catarrhal mastitis treatment
- Prevention of catarrhal mastitis
The reasons for the development of catarrhal mastitis
Most often, catarrhal mastitis is associated with the lactation period.
Distinguish between catarrhal inflammation of the milk ducts and catarrhal inflammation of the alveoli, which may be due to the following reasons:
- Getting staphylococcal infection into the ducts of the mammary gland and into the alveoli from the outside. It is staphylococci that more often than other bacteria provoke the development of mastitis.
- The penetration of microorganisms into the mammary gland with the blood flow and through the milk ducts from the internal foci of infection present in the body of the woman herself. In this case, the tissue of the gland can be infected with E. coli or streptococcus. It should be noted that by the lymphogenous and hematogenous route, bacteria penetrate into the mammary gland much less frequently.
Infection can occur through contact with nosocomial bacteria, for example, by contact with infected linen, household items, etc. As a rule, hospital strains are the most resistant to treatment and are much more difficult to eradication.
Infection can also occur after direct contact with the carrier outside the walls of the hospital room. Both an adult and a child, including a newborn, are capable of carrying the infection.
Naturally, the bacterium itself, after getting on the skin of the breast, is not able to penetrate into the alveoli and milk ducts.
This requires predisposing factors, among which are:
- The presence of a defect in the nipple: flat, inverted, lobed, etc.
- Injuries and cracks in the nipple.
- Mastopathy.
- Improper attachment of the baby to the breast.
- Inappropriate expression of milk, leading to its stagnation.
- The presence of rough scars on the nipples, which have formed after surgery, for example, after the removal of benign neoplasms.
- Pathology of pregnancy and childbirth.
- Complications after childbirth.
- Decreased immunity, both local and general.
- Postponed viral infections.
- The presence of a chronic focus of infection in the body.
- Sudden hypothermia.
- Nervous and physical exhaustion.
If a woman does not properly care for her breasts or ignores the rules of personal hygiene, then this can lead to the fact that the cracks in the nipples will worsen, which means that it will not be difficult for pathogenic flora to penetrate the tissues of the mammary glands.
Catarrhal mastitis symptoms
The symptoms of catarrhal mastitis can manifest themselves in different ways.
If inflammation of the milk ducts occurs, then the clinical picture is as follows:
- The part of the breast, which is located near the nipple, increases in size.
- The nipple canal becomes narrow.
- On palpation, it is possible to detect seals that are in the shape of peas, but the skin of the breast does not redden or swell.
- The woman does not experience pain.
- The general condition of the body is not disturbed, the body temperature does not rise.
- If a woman is breastfeeding, then impurities and flakes may appear in the milk at the initial stage of expression. Further, normal milk comes out.
For inflammation of the alveoli, the following symptoms of catarrhal mastitis are characteristic:
- The general condition of the woman is deteriorating.
- Body temperature rises to febrile levels. This leads to the fact that signs of intoxication of the body join, including headaches, lack of appetite, weakness, sweating, chills.
- Pulse, heartbeat, breathing quickens.
- The affected part of the breast increases in volume.
- The breasts become sore and hot, and the skin on it turns red.
- Seals form inside the breast.
- If catarrhal mastitis develops against the background of lactation, then the volume of milk to be separated decreases, flakes and curdled clots appear in it.
- The acidity of the milk becomes high.
If catarrhal mastitis is not treated, then it will turn into a purulent, and then into a gangrenous form.
They are characterized by the following symptoms:
- The body temperature is constantly kept at high marks and gets lost only for a short period of time. The inflamed breast itself is constantly hot.
- Signs of intoxication join, sleep suffers, constant headaches are present.
- In the inflamed area of the gland, a fluctuation symptom appears, which indicates the presence of pus in a confined space.
- The lymph nodes located next to the mammary gland increase in size and become painful.
- It is possible to form both internal and external areas of the abscess filled with pus.
The gangrenous form of catarrhal mastitis is the most severe. On the chest, areas of necrosis are formed, which are filled with hemorrhagic contents. Gradually, the swelling spreads to the surrounding tissues. A similar complication requires removal of the breast.
Diagnosis of catarrhal mastitis
If you suspect the development of catarrhal mastitis, you should consult a doctor. If a woman is breastfeeding, then with a mild course of the disease, a gynecologist is engaged in diagnostics and treatment. When mastitis does not develop against the background of lactation, then consultation with a mammologist and a surgeon is imperative.
The diagnosis is made on the basis of examination after analyzing the patient's complaints.
To confirm it, the following studies may be required:
- General blood analysis.
- General urine analysis.
- Bacterial examination of milk or exudate from the mammary glands. If necessary, a cytological analysis of the fluid is performed.
- Ultrasound of the breast is performed if a purulent process is suspected.
- Puncture of the infiltrate is performed with the development of an abscess or cellulitis of the mammary gland against the background of mastitis.
As for mammography, it is performed quite rarely, for example, in the chronic course of mastitis and the impossibility of accurate differentiation of the diagnosis.
Catarrhal mastitis treatment
The leading task in the treatment of catarrhal mastitis is to prevent the spread of inflammation from the milk ducts to the alveolar ducts. Therefore, you must act very quickly. With a timely visit to the doctor, treatment is carried out on an outpatient basis. If the disease did not have time to pass into the purulent stage, the woman's well-being is not disturbed, then it is often possible to do without even using antibiotics.
Conservative treatment is reduced to the following procedures:
- Express milk and feed your baby regularly. This will relieve chest congestion.
- Massage of the mammary gland is performed both subject to the presence of lactation and with non-lactational catarrhal mastitis. The nodes that appear must be kneaded from top to bottom using iodine, camphor or salicylic ointment. Massage the breasts towards the nipples, at least once every 2 hours.
- During treatment, you should limit fluid intake and give preference to dry food.
- With a slight increase in body temperature, it is necessary to take drugs from the NSAID group, for example, Ibuprofen. They allow not only to lower body temperature, but also to reduce the severity of the inflammatory response.
- Antispasmodics, such as No-shpa or Drotaverinum, can eliminate discomfort in the mammary gland.
- If mastitis is of a non-infectious nature, then Traumgel ointment is applied to the chest.
- Infectious catarrhal mastitis requires broad-spectrum antibiotics. The drugs of choice are: Amoxiclav, Augmentin, Cefalexin, Cefotaxime. The medicinal product should be selected by the doctor, depending on what kind of bacteria triggered the development of catarrhal mastitis. If a woman is breastfeeding, and they plan to maintain lactation, then she is strictly prohibited from taking antibiotics from such pharmacological groups as tetracyclines, fluoroquinolones, sulfonamides, lincosamides.
If a woman's condition improves after a day, it is possible to undergo physiological procedures: ultrasound therapy, UHF therapy. They are aimed at the speedy resorption of the formed infiltrate and at normalizing the function of the mammary gland.
As for the imposition of compresses, they can only be used when the mastitis is of a non-infectious nature. For this purpose, you can use warming compresses with semi-alcohol dressings, which are left overnight. After removing the compress, the breast must be rinsed with water. Before starting to practice local treatment, it is necessary to consult a doctor.
If a woman has purulent mastitis, then warming compresses are categorically contraindicated. They are able to aggravate the course of the disease and provoke such a formidable complication as sepsis.
In the case when conservative therapy does not give the desired results, or a woman has sought medical help at the stage of purulent inflammation, surgical treatment cannot be avoided.
After the patient is hospitalized, the abscess area is opened, the pus accumulated in the tissues is removed, the wound is treated with antiseptic solutions and drainage is installed. The operation is performed under general anesthesia.
To clarify the diagnosis, the removed fragment of the abscess is sent for histological examination, since the malignancy of the process is possible.
Prevention of catarrhal mastitis
Since the leading factor in the development of mastitis is lactostasis, every effort should be made to prevent milk stagnation.
The complex of preventive measures is aimed at achieving the following goals:
- The baby should be applied to the breast as early as possible.
- It is always better to feed your baby at the same time, which will allow you to set a certain physiological rhythm.
- During lactation, a woman should sleep on her side or back.
- Do not deliberately shorten the feeding time of your baby.
- With a tendency to stagnate milk, it is necessary to carry out a circular shower a quarter of an hour before the start of feeding.
- Milk must be expressed correctly, paying particular attention to the outer quadrant of the breast.
- The correct feeding technique will prevent the formation of cracks in the nipples, which are the gateway to infection.
- You should wear underwear from cotton fabric, make sure that the surface of the bra is always dry and clean.
- It is important to promptly sanitize the foci of infection in the body. This applies to dental caries, purulent glands, sinusitis.
- The chest must be protected not only from injuries, but also from hypothermia.
The psychological comfort and mental balance of a woman is no less important. You should also avoid physical overwork, eat right and get enough sleep. Adequate and timely treatment of skin lesions of the breast will prevent the development of non-lactational catarrhal 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.
