Fever of 38.5°C or more, flu-like aches, chills and a tender, erythematous and edematous area of the breast is observed in puerperal mastitis [1]. Women often report of malaise and fatigue as well [5].

• Fever

  Symptoms include high fever, fatigue and a painful, red, swollen and tender area of the breast that makes the condition easy to recognize. [symptoma.com]

  Mastitis Clasificación y recursos externos CIE 10 N61 CIE 9 … Wikipedia Español Puerperal fever — Streptococcus pyogenes (red stained spheres) is responsible for most cases of severe puerperal fever. [esacademic.com]

  Abstract Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. [ncbi.nlm.nih.gov]

  A number of factors can cause fever—a temperature of 38.0°C (100.4°F) or higher—in the puerperium. Most persistent fevers after childbirth are caused by genital tract infection. [accessmedicine.mhmedical.com]

  Clinically, these patients present with a rapid onset of unilateral breast tenderness, redness, fever, and sometimes a thickening or mass. Breast infections can be very aggressive with high fevers developing quickly. [brooksidepress.org]

• Chills

  Clinical signs are fever, chills, fatigue, and the presence of a tender, edematous, erythematous area of the breast that is inflamed and painful. [symptoma.com]

  […] and cracked or fissured nipples - poor breast feeding technique; improper latch - decrease in frequency of breast feeding - poor hygiene and inadequate hand washing Mastitis: signs and symptoms - painful or tender mass - reddened area on one breast - chills [quizlet.com]

  However, systemic symptoms such as fever and chills are not present, which helps to differentiate the condition from mastitis. [news-medical.net]

  The fever and chills give it away, as does a red, wedge-shaped area on the breast that points toward the nipple. [webmd.com]

  Flu-like symptoms – such as chills and fever – typically are present, together with pain and redness in the affected area of the breast. [dr-mom.com]

• Swelling

  Treatment of acute puerperal mastitis includes antistaphylococcal antibiotic coverage within the first 48 hours, with ultrasound examination in the presence of persistent induration, swelling, or tenderness to diagnose breast abscess. [ncbi.nlm.nih.gov]

  Mastitis is infection of the breast tissue, which causes pain and swelling in the affected breast. Women with this condition may also experience fevers and chills. [news-medical.net]

  You might also have swelling in your legs and feet, feel constipated, have menstrual-like cramping. Even if you are not breastfeeding, you can have milk leaking from your nipples, and your breasts might feel full, tender, or uncomfortable. [icdlist.com]

  Don’t do this for more than a couple of minutes, as too much heat may worsen swelling. [medela.com]

• Malaise

  The presence of mastitis can be diagnosed by tenderness in breast and is associated with malaise and fever. The doctor will advise you antibiotics for Staphylococcus aureus (cephalexin, dicloxacillin, etc.) [beingtheparent.com]

  Dairy overload with consequent incomplete emptying Nasopharynx infection in the infant primiparity Puerperal mastitis symptoms Patients come to see when they have: 38-39 ° fever, chills, malaise. Local mastalgia and then generalized. [topdoctors.es]

  […] full musical promo — due out next week — but it's a real treat for anyone who can sympathize with lyrics like these: My boobs are swollen, red and sore / I leak a lot, then I leak some more / Fever's got me down for days / It's what the doctors call malaise [today.com]

  Symptoms Puerperal mastitis often starts off as a feeling of malaise. You may complain of body aches and feeling unwell before the pain and soreness of the breast becomes evident. [home-remedies-for-you.com]

  Women often report of malaise and fatigue as well. The diagnosis should be made rather easily based on clinical findings. [symptoma.com]

• Burning Pain

  Symptoms of mastitis can include: a red, swollen area on your breast that may feel hot and painful to touch a breast lump or area of hardness on your breast a burning pain in your breast that may be continuous or may only occur when you are breastfeeding [nhs.uk]

  If you have thrush, you may also have: a burning pain in your breast very itchy breasts pain that is worse at night or after feeding Your doctor may prescribe a cream that you will need to apply to your breasts after every feed, for two weeks. [your.md]

• Constipation

  Use a donut soft cushion while sitting Hemorrhoids And Constipation: Pain and blood discharge during defecation is also seen in the post partum phase. The situation can be cured by taking OTC (over the counter medicine). [beingtheparent.com]

  You might also have swelling in your legs and feet, feel constipated, have menstrual-like cramping. Even if you are not breastfeeding, you can have milk leaking from your nipples, and your breasts might feel full, tender, or uncomfortable. [icdlist.com]

  Apparently the most common complaints are hemorrhoids, constipation, bleeding, and mastitis. Head over to Willow’s site, balancingyourhealth.com to learn more about natural remedies for those. Consume Your Placenta What?! Yes, you read that right. [thewholejourney.com]

• Chest Pain

  These issues are temporary and can be resolved through medical and your partner’s support Pulmonary emboli: The condition is characterized by presence of sudden intense chest pain, pallor, cyanosis, dyspnoea, raised jugular pressure, hypotension, confusion [beingtheparent.com]

  Exciting this point with the fingers can help in relieving breast pain, mastitis, distension and abscess. It is also useful in treating general chest pain, oppression and fullness of the chest. [modernreflexology.com]

• Fracture

  New England Medical Monthly and The 1746 Presse Medicale Belgium W 4 4 Diseases of the Heart Diagnosis of P F ment des Lcucemies par les Rayons 21 Functional Disorders Important Factor in p 407 76 C Geiger85c Dec 150 Dec 1 p 1077 Colics Fracture Treatment [books.google.ro]

  Benefits to mother: Reduces risk of breast cancer (dose-response effect) Reduces risk of ovarian cancer (dose-response effect) Little or no evidence for protection from postpartum depression, fractures from osteoporosis long-term, or return to pre-pregnancy [clinicaladvisor.com]

• Hip Pain

  Acupressure Points for Back Pain, Hip Pain and Sciatica Carrying the baby in the womb for 9 long moths puts a lot of stress on the pelvic region of the mother and back pain, hip pain and sciatica are some of the common complaints of new mothers. [modernreflexology.com]

• Erythema

  Abstract Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. [ncbi.nlm.nih.gov]

  The complaint in this case is of swollen and tender breasts bilaterally, without fever or erythema. Signs Breast examination reveals unilateral oedema, erythema in a wedge-shaped area, and tenderness. The affected area feels firm and hot. [patient.info]

  Mastitis symptoms may include high fever and breast symptoms: erythema, induration, tenderness, pain, swelling, and warmth to the touch. [msdmanuals.com]

  Mastitis is most commonly unilateral.11 On examination of the breast, the erythema is segmental, usually in the upper, outer quadrant,12 with variable degrees of induration.9 A palpable, fluctuant mass should raise clinical suspicion of a breast abscess [glowm.com]

• Blister

  The nipple may also be flattened, crusting, blistered or retracted. However, systemic symptoms such as fever and chills are not present, which helps to differentiate the condition from mastitis. [news-medical.net]

  Dealing with a Bleb / Milk blister, Before it Turns into an Infection Symptoms of Breast Infection Mastitis Symptoms: One side of the breast can become larger than the other. Breast lumps may occur. Sore breast (tender breast). [breastfeeding-problems.com]

  If you have a white spot on your nipple alongside symptoms of mastitis, see the section about milk blisters or blebs in Blisters on Nipples for ideas of how to clear it. Summary Mastitis is the name for an inflammation in the breast. [breastfeeding.support]

  —>You may also have a milk blister or “bleb”, which may be related. To find out more, go here. Mastitis Ooooh, now we’re getting into the FUN stuff. [lucieslist.com]

  Call your doctor if you have other breast problems like cracked and bleeding nipples or blisters on your nipples that are not relieved by home treatment. [uofmhealth.org]

• Flushing

  Hormones gone crazy + tons of extra fluid = a body trying to flush itself out. I genuinely want to know why no one warns mothers about this, because I’ve worked as an OB nurse for years and never once heard someone talk about it. [babble.com]

• Breast Engorgement

  Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. [ncbi.nlm.nih.gov]

  The added breast and nipple pain and soreness from breast engorgement can cause frustration as well. Symptoms of breast engorgement are breast fullness, firmness and nodularities that occur around the nipple or in the breast tissue. [babiesafter35.com]

  What do engorged breasts feel like? Engorgement can happen in one or both breasts. [medela.com]

  Approximately 15 percent of women who do not breast feed develop postpartum fever from breast engorgement. As discussed in Chapter 36 ( Maternal Care During the Puerperium ), the incidence of fever is lower in breast-feeding women. [accessmedicine.mhmedical.com]

  Maternal intravenous fluids and postpartum breast changes: a pilot observational study. Int Breastfeed J 10, 18 (2015). Mangesi L and Dowswell,T. Treatments for breast engorgement during lactation (Review). The Cochrane Library 9, (2010). [medela.jp]

• Breast Mass

  The main concern of many women presenting with a breast mass is the likelihood of cancer. Reassuringly, most breast masses are benign. Ultrasonogram demonstrates a hypoechoic mass with smooth, partially lobulated margins typical of a fibroadenoma. [emedicine.medscape.com]

  The milk ducts near the nipple become inflamed, causing breast pain. There may also be a breast mass near the nipple, retraction of the nipple, or discharge. [jamanetwork.com]

  Fibroadenomas can also be confused with a breast mass. Typically, they do not become infected. Breast cancer (inflammatory breast cancer) must be considered in atypical presentations or those not responding to initial therapy. [clinicaladvisor.com]

  Cat scratch disease Lupus Commonly Associated Conditions Breast abscess Diagnosis Fever and malaise Nausea ± vomiting Localized breast tenderness, heat, and redness Possible breast mass History Breast tenderness “Hot cords burning in chest wall” Physical [tipsdiscover.com]

  IGLM often forms a palpable breast mass that can mimic invasive breast cancer, both on a mammogram and clinical examination. It is important to note that IGLM is a benign condition. [breast-cancer.ca]

• Mastodynia

  Your doctor may call it mastalgia, mammalgia, mastodynia, or simply breast soreness. Even before you became pregnant you may have experienced changes in your breasts. [momsintofitness.com]

• Large Breast

  1, 11, 12] Primary skin infections of the breast (cellulitis or abscess) most commonly affect the skin of the lower half of the breast and often recur in women who are overweight, have large breasts, or have poor personal hygiene. [3] Breast masses can [emedicine.medscape.com]

• Excitement

  Evidence for the generation of an electronic excitation state(s) in human polymorphonuclear leukocytes and its participation in bactericidal activity. Biochem. Biophys. Res. ‎ Seite 201 - Wall. 2001. [books.google.de]

  Find out more about this exciting new development through this step by step guide. [cabdirect.org]

  Whereas in pregnancy, when wearing maternity clothing is exciting and totally comfortable, wearing maternity clothes postpartum is just downright depressing. 8. Tears, tears, and more tears. [babble.com]

  Health News Interactive Tools Multimedia Newsletters Online Resources News Center Health News Newsletters Tools & Multimedia Podcasts Video Library Calculators Quizzes Risk Assessments Symptom Checker WELLNESS CENTER Pregnancy & Newborns Pregnancy is an exciting [childrenshospital.vanderbilt.org]

  Exciting this point with the fingers can help in relieving breast pain, mastitis, distension and abscess. It is also useful in treating general chest pain, oppression and fullness of the chest. [modernreflexology.com]

• Agitation

  The common symptoms of bipolar disorder are Decreased desire for sleeping Grandiosity Distractabiltiy Psychomotor agitation Schizophrenia: It is a rare complication of postpartum phase and is common if the mother has some difficulty in coping with her [beingtheparent.com]

• Seizure

  The treatment for postpartum preeclampsia requires a hospital admission and administration of magnesium sulfate which is given to help decrease the risk of seizures. A doctor may also start a new mother on medications to control her blood pressure. [babiesafter35.com]

The diagnosis should be made rather easily based on clinical findings [5]. It is important to identify the causative agent, however and cultivation of aspirated samples should be performed, the primary reason being determination of optimal antimicrobial therapy due to the growing issue of antimicrobial resistance, particularly in the setting of MRSA [3].

Antimicrobial therapy is the mainstay of puerperal mastitis treatment. For non-MRSA organisms, dicloxacillin (500 mg PO q6h) or cephalexin (500 mg PO q6h) are given in the outpatient setting, whereas nafcillin or oxacillin 2 g IV q4-6h is recommended once patients are admitted [4]. When MRSA is suspected, trimethoprim-sulfamethoxazle (TMP-SMX) is given as a double-strength tablet every 12 hours [4]. Alternative regimens include clindamycin 300 mg PO q6h for outpatients, while intravenous vancomycin 1 gm q12h is recommended in hospital conditions [4]. If an abscess in the breast has developed, surgical drainage or needle aspiration, in addition to antibiotic therapy, is necessary [5]. In addition to antibiotics and surgery, non-steroidal anti-inflammatory drugs (NSAIDs) should be given to reduce the symptoms provoked by inflammation [3].

The prognosis is good with early therapy, but complications may occur, most notable being breast abscess [2], while rare cases have described sepsis as a complication, suggesting the importance of an early diagnosis.

The most important causative agents of puerperal mastitis are Staphylococcus aureus and coagulase-negative staphylococci (CoNS) [1], whereas Streptococcus pyogenes, Escherichia coli, Bacteroides sp., Pseudomonas aeruginosa, Proteus mirabilis and Corynebacterum sp. (rare) are other notable pathogens [4] [7]. Unfortunately, an increased frequency of Methicillin-resistant S. aureus (MRSA) infection has been observed [6].

Overall prevalence of puerperal mastitis ranges between 10% in the United States, 15-20% in Australia and up to 24% in Finnish women [1] [2]. Risk factors associated with mastitis are nipple damage, maternal fatigue, milk stasis, history of mastitis, use of an antifungal nipple cream and an increased frequency of breastfeeding [2]. Some studies have determined that African American women are at a higher risk for the development of a breast abscess, as are obese women and cigarette smokers [7].

Bacterial colonization of the breast and its connective tissue is the principal event in the pathogenesis of puerperal mastitis. Presumably, milk stasis, nipple damage and other factors promote invasion of microbial organisms into the breast, leading to acute inflammation and the appearance of symptoms.

Complete emptying of the breast, optimization of breastfeeding techniques and a reduction in breastfeeding frequency (< 10 times per week) are strategies that can reduce the risk for mastitis [2] [5], but so far, neither of the mentioned strategies have been confirmed in large-scale studies [3].

Puerperal (or lactation) mastitis is a term that describes inflammation of the interlobular connective tissue within the mammary gland during puerperium - the first 6 weeks postpartum [1]. Most common causes are Staphylococcus aureus, coagulase-negative staphylococci (CoNS) and other bacterial pathogens, but microbial invasion may not be the cause in all cases [2]. Approximately 10-25% of women develop puerperal mastitis in different parts of the world and risk factors include nipple damage, milk stasis, previous history of mastitis and an increased breastfeeding frequency [2]. Clinical signs are fever, chills, fatigue, and the presence of a tender, edematous, erythematous area of the breast that is inflamed and painful [1]. The diagnosis is made on clinical grounds and cultivation of aspirated breast fluid should be performed to identify the causative agent [3]. Antibiotics are the mainstay of therapy, but it is imperative to conduct antimicrobial susceptibility testing, to initiate optimal treatment and to avoid the risk of resistance [4]. Mastitis does not pose a risk for the infant and breastfeeding should not be ceased during the infection [5], but it is important to recognize the condition early on and treat it appropriately, as breast abscesses (but also sepsis) can occur.

Puerperal mastitis is a term that describes inflammation of breast tissue in the first 6 weeks after delivery (known as the puerperium). In most cases, bacterial organisms such as Staphylococcus aureus cause an infection that leads to inflammation. Approximately 10% of women in the United States develop puerperal mastitis, while somewhat higher rates (15-25%) have been observed in Australia and Finland. Various risk factors have been described - nipple damage, milk stasis, previous history of mastitis and increased breastfeeding frequency, all promoting colonization of breast tissue with bacteria. Symptoms include high fever, fatigue and a painful, red, swollen and tender area of the breast that makes the condition easy to recognize. Nevertheless, it is necessary to identify the organism responsible for the infection, in order to determine optimal antibiotic therapy, the mainstay of treatment. In rare cases, breast abscesses and even sepsis can ensue, which is why early recognition of the infection is vital. Preventive strategies such as complete emptying of the breast, reduced breastfeeding frequency and correction of breastfeeding techniques have been proposed, but their true effects are yet to be confirmed.

1. Amir LH, Forster DA, Lumley J, McLachlan H. A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants. BMC Public Health. 2007;7:62.
2. Foxman B, D'Arcy H, Gillespie B, Bobo JK, Schwartz K. Lactation mastitis: Occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002;155:103-114.
3. Bharat A, Gao F, Aft RL, et al. Predictors of primary breast abscesses and recurrence. World J Surg. 2009;33(12):2582-2586.
4. Schoenfeld EM, McKay MP. Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm? J Emerg Med. 2010;38(4):e31-34.
5. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008;78(6):727-731.
6. Gilbert DN, Chambers HF, Eliopoulos GN, Saag MS. The Sanford Guide to Antimicrobial Therapy 2015. 45th ed. Antimicrobial Therapy, Inc, Sperryville, VA; 2015.
7. Cusack L, Brennan M. Lactational mastitis and breast abscess - diagnosis and management in general practice. Aust Fam Physician. 2011;40(12):976-979.