Rizzo Monica, Peng Limin, Frisch Anna, Jurado Maria, Umpierrez Guillermo
Department of Surgery, Avon Comprehensive Breast Center at Grady, Atlanta, Georgia, USA.
Am J Med Sci. 2009 Aug;338(2):123-6. doi: 10.1097/MAJ.0b013e3181a9d0d3.
The association between diabetes and breast abscess in nonlactating women has not been previously reported in the literature.
Retrospective analysis of all cases of breast abscess in nonlactating women in a community teaching hospital from 2000 to 2006. We analyzed their clinical characteristics, prevalence of diabetes mellitus (DM), management, and clinical outcome.
We identified 116 breast abscesses in 98 nonlactating women [age 48 +/- 14, (mean +/- SD), 89% African Americans]. At presentation, 63 patients (64%) had a known history of DM (duration: 8.5 +/- 5 years) and 8 patients (8%) had newly diagnosed DM. Among the remaining 27 women, 7 (26%) developed DM within 5 years of follow-up. The odds ratio of having diabetes in nonlactating women with breast abscess relative to those without breast abscess was estimated as 14.24 (95% confidence interval, 6.72-30.17). Most patients (89%) had a single abscess. Patients with DM had increased length of hospital stay (P < 0.01) and a more severe clinical course during follow-up. Most patients (70%) were treated with incision and drainage and antibiotics. Glycemic control was suboptimal with only 46% of subjects receiving insulin therapy during the hospital stay.
Our study indicates a strong association between DM and breast abscess in nonlactating women. The high prevalence of DM (72%) and their more severe clinical course suggest that breast abscesses in nonlactating women should be considered among the "typical" infections associated with DM. Increased awareness and intensified glycemic control might improve clinical outcome in nonlactating women with breast abscesses.
糖尿病与非哺乳期女性乳腺脓肿之间的关联此前在文献中未见报道。
对一家社区教学医院2000年至2006年期间所有非哺乳期女性乳腺脓肿病例进行回顾性分析。我们分析了她们的临床特征、糖尿病（DM）患病率、治疗方法及临床结局。
我们在98名非哺乳期女性中识别出116例乳腺脓肿[年龄48±14岁，（均值±标准差），89%为非裔美国人]。就诊时，63例患者（64%）有DM病史（病程：8.5±5年），8例患者（8%）为新诊断的DM。在其余27名女性中，7名（26%）在随访的5年内患DM。非哺乳期乳腺脓肿女性患糖尿病相对于无乳腺脓肿女性的比值比估计为14.24（95%置信区间，6.72 - 30.17）。大多数患者（89%）有单个脓肿。DM患者住院时间延长（P < 0.01），随访期间临床病程更严重。大多数患者（70%）接受切开引流及抗生素治疗。血糖控制欠佳，住院期间仅46%的患者接受胰岛素治疗。
我们的研究表明DM与非哺乳期女性乳腺脓肿之间存在密切关联。DM的高患病率（72%）及其更严重的临床病程表明，非哺乳期女性的乳腺脓肿应被视为与DM相关的“典型”感染之一。提高认识并加强血糖控制可能改善非哺乳期乳腺脓肿女性的临床结局。
