Breast infection
If clinical examination should lead to the suspected diagnosis of a breast abscess or infective (usually puerperal) mastitis, please follow this protocol:
- Arrange (same day) ultrasound to confirm diagnosis +/- guided needle aspiration (rather than incision) [Bestbets].
- If ultrasound examination confirms an abscess (or it is impossible to arrange), apply local anaesthetic cream to the most fluctuant area of skin and leave for one hour.
- Aspirate the area with a large bore needle (or grey venflon) and send pus for microbiology.
- Whether pus is obtained or not, prescribe a seven day course of Augmentin (625 mg tds) to all patients unless allergic to Penicillin.
- Erythromycin (500 mg tds) is then a suitable alternative. (Beware if on Warfarin)
- Most patients will not require to be admitted unless toxic, conservative treatment has failed or the abscess needs to be incised and drained because of imminent discharge through the skin.
- If the patient is breastfeeding, advise that it is still safe to continue.
- Arrange referral to one of the general surgical consultants so that further management can continue.
- This appointment can be made through xxxxxxx during office hours.
