IS Case 431: Puerperal breast abscess
Imaging Sciences URMC 2010
Publication Date: 2010-08-27
Puerperal breast infection is common during breast-feeding. The nipple-areola epithelium is interrupted by retrograde spread of organisms from nursing baby's nose and throat. Milk stasis provides a culture medium for organisms. The most common organisms are Staph aureus and Streptococcus. S aureus frequently causes abscesses and can be focal and invasive even at onset. Streptococcus usually only causes abscess in advanced stages. If mastitis is caught early and treated with antibiotics, abscess can be avoided.
On mammography, abscesses may appear as ill-defined masses. Ultrasound is the most important modality for diagnosing abscess. Ultrasound demonstrates irregular, hypoechoic or anechoic masses, with or without fluid-debris levels and posterior acoustic enhancement.
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