Mastitis and breast abscess in infants younger than two months
- Nirupama K De Silva, MD
Nirupama K De Silva, MD
- Clinical Associate Professor
- University of Oklahoma-Tulsa
- Régine Fortunov, MD
Régine Fortunov, MD
- Assistant Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
The clinical features, evaluation, and management of mastitis and breast abscess in infants <2 months will be discussed in this topic review. Mastitis and breast abscess are less common in infants ≥2 months than in younger infants. The evaluation and management of mastitis in infants ≥2 months are similar to those in older children. Mastitis and breast abscess in older children and adolescents, lactational mastitis, and breast infections in adult women are discussed separately.
●(See "Lactational mastitis".)
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- Faden H. Mastitis in children from birth to 17 years. Pediatr Infect Dis J 2005; 24:1113.
- Stricker T, Navratil F, Sennhauser FH. Mastitis in early infancy. Acta Paediatr 2005; 94:166.
- Walsh M, McIntosh K. Neonatal mastitis. Clin Pediatr (Phila) 1986; 25:395.
- Rudoy RC, Nelson JD. Breast abscess during the neonatal period. A review. Am J Dis Child 1975; 129:1031.
- Efrat M, Mogilner JG, Iujtman M, et al. Neonatal mastitis--diagnosis and treatment. Isr J Med Sci 1995; 31:558.
- Brook I. The aerobic and anaerobic microbiology of neonatal breast abscess. Pediatr Infect Dis J 1991; 10:785.
- Montague EC, Hilinski J, Andresen D, Cooley A. Evaluation and treatment of mastitis in infants. Pediatr Infect Dis J 2013; 32:1295.
- Stetler H, Martin E, Plotkin S, Katz M. Neonatal mastitis due to Escherichia coli. J Pediatr 1970; 76:611.
- Burry VF, Beezley M. Infant mastitis due to gram-negative organisms. Am J Dis Child 1972; 124:736.
- Schwarz MD, Rosen RA. Neonatal mastitis due to E. coli. Clin Pediatr (Phila) 1974; 13:86.
- McGuigan MA, Lipman RP. Neotal mastitis due to Proteus mirabilis. Am J Dis Child 1976; 130:1296.
- Rench MA, Baker CJ. Group B streptococcal breast abscess in a mother and mastitis in her infant. Obstet Gynecol 1989; 73:875.
- Sloan B, Evans R. Clinical pearls: neonatal breast mass. Acad Emerg Med 2003; 10:269.
- Fortunov RM, Hulten KG, Hammerman WA, et al. Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics 2006; 118:874.
- Montalto M, Lui B. MRSA as a cause of postpartum breast abscess in infant and mother. J Hum Lact 2009; 25:448.
- Al Ruwaili N, Scolnik D. Neonatal mastitis: controversies in management. J Clin Neonatol 2012; 1:207.
- Michael IK, Howard FH. Osteomyelitis due to penicillin-resistant staphylococci in infancy following suppurative mastitis. (Report of a case). J Trop Pediatr 1960; 6:19.
- Fortunov R, Mednax/Pediatrix Medical Group, 2009, personal communication.
- Stauffer WM, Kamat D. Neonatal mastitis. Pediatr Emerg Care 2003; 19:165.
- Hsieh WS, Yang PH, Chao HC, Lai JY. Neonatal necrotizing fasciitis: a report of three cases and review of the literature. Pediatrics 1999; 103:e53.
- Nelson JD. Suppurative mastitis in infants. Am J Dis Child 1973; 125:458.
- Bodemer C, Panhans A, Chretien-Marquet B, et al. Staphylococcal necrotizing fasciitis in the mammary region in childhood: a report of five cases. J Pediatr 1997; 131:466.
- Fleisher, GR. Infectious disease emergencies. In: Textbook of Pediatric Emergency Medicine, 5th, Fleisher GR, Ludwig S, Henretig FM (Eds), Liippincott Williams & Wilkins, Philadelphia 2006. p.783.
- Day CT, Kaplan SL, Mason EO, Hulten KG. Community-associated Staphylococcus aureus infections in otherwise healthy infants less than 60 days old. Pediatr Infect Dis J 2014; 33:98.
- Fortunov RM, Hulten KG, Hammerman WA, et al. Evaluation and treatment of community-acquired Staphylococcus aureus infections in term and late-preterm previously healthy neonates. Pediatrics 2007; 120:937.
- Torres-Day C, Baylor College of Medicine, 2013, personal communication.
- DiVasta AD, Weldon C, Labow BI. The breast: Examination and lesions. In: Emans, Laufer, Goldstein's Pediatric & Adolescent Gynecology, 6th ed, Emans SJ, Laufer MR (Eds), Lippincott Williams & Wilkins, Philadelphia 2012. p.405.
- Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg 2001; 182:117.
- Baren JM. Breast lesions. In: Textbook of Pediatric Emergency Medicine, 5th ed, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott Williams and Wilkins, Philadelphia 2006. p.193.
- Masoodi T, Mufti GN, Bhat JI, et al. Neonatal mastitis: a clinico-microbiological study. J Neonatal Surg 2014; 3:2.
- Bradley JS, Wassel RT, Lee L, Nambiar S. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics 2009; 123:e609.
- Borders H, Mychaliska G, Gebarski KS. Sonographic features of neonatal mastitis and breast abscess. Pediatr Radiol 2009; 39:955.
- Panteli C, Arvaniti M, Zavitsanakis A. Long-term consequences of neonatal mastitis. Arch Dis Child 2012; 97:673.
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSIS
- ADDITIONAL EVALUATION
- Supportive care
- Drainage of breast abscess
- Antimicrobial therapy
- - Route of empiric therapy
- - Choice of regimen
- - Duration of therapy
- RESPONSE TO THERAPY
- Monitoring response
- Failure to respond
- SUMMARY AND RECOMMENDATIONS