Diagnosis and treatment of acute mastitis

  Mastitis can be divided into acute mastitis and chronic mastitis according to the course of the disease. Acute mastitis is an acute purulent infection of the mammary glands, mostly seen in primiparous women, with onset 3-4 weeks after delivery.  I. Etiology Milk stagnation and bacterial invasion. The main pathogenic bacteria are Staphylococcus aureus II. Clinical manifestations 1. Symptoms: Initially, the patient’s breast skin is red, swollen, feverish and painful, and a painful hard lump appears in the affected area, and fever may occur. If the inflammation continues to develop, the above symptoms are aggravated, and in severe cases, chills, high fever, rapid pulse rate, significantly higher white blood cell count, and even sepsis.  2. Physical examination: generally at first cellulitis-like manifestations, and abscesses may be formed after a few days.  The main reason is to eliminate the infection and empty the milk. 1. When early cellulitis is manifested, anti-inflammatory treatment is the main focus, supplemented by local physiotherapy and topical application of Jinhuang San (cream), etc. Cold compresses can be applied within 48 hours, and hot compresses can be applied after 48 hours. At the same time, the breast should be lifted with a bra.  (1) It is not necessary to return to breastfeeding during this period. You can suspend breastfeeding on the affected breast, clean the nipple and areola, promote milk excretion (with a breast pump or sucking), and empty the milk as much as possible.  (2) You can take oral Chinese medicine such as dandelion, wild chrysanthemum and other heat-clearing and detoxifying drugs, and adult medicine such as Xinhuang tablet.  (3) The choice of antibacterial drugs is safe with penicillin, cephalosporin and erythromycin. Because antibacterial drugs can be secreted to breast milk and affect the health of infant, so drugs such as tetracycline, aminoglycosides, sulfonamides and metronidazole should be avoided.  2.After abscess formation, the main treatment measure is to make abscess incision and drainage in time, and at the same time anti-inflammatory treatment. In the drainage, the separation between the abscess cavities in multiple rooms should be opened to fully drain the abscess, to pass the drainage, and to let the breast skin incision heal after the internal breast gradually improves. During this period, breastfeeding should be returned and stopped.