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非哺乳期女性的乳腺感染

Breast infections in non-lactating women.

作者信息

Abdelhadi Maha S A, Bukharie Huda A

机构信息

Department of Surgery, College of Medicine, King Faisal University, Dammam, Saudi Arabia.

出版信息

J Family Community Med. 2005 Sep;12(3):133-7.

Abstract

BACKGROUND

Breast infection in lactating mothers is a common entity which in the majority of cases can be explained by ascending infections. However, it has been noticed that the number of non lactating women presenting with breast abscesses is rising. This study attempts to explore the sensitivity pattern of organisms and underlying cause of breast infections in non-lactating women.

MATERIALS AND METHODS

This review was undertaken at King Fahd of the University, Alkhobar, Saudi Arabia between 1991-2003. All patients presenting with breast infections were included. Medical records, operative notes, cultures, histopathology reports and outcome were reviewed.

RESULTS

The number of patients presenting with breast infections accounted for 179(3.5%) out of the total number of patients 6314 with variable breast complaints. Infection occurred in 136(76%) lactating women (Group I) ,while Non lactating (Group II) breast infections accounted for 43(24%). Age ranged from 24 years to 52 years. Underlying clinical conditions were found in 26 patients(60%) in Group II namely granulomatous mastitis13(50%), duct ectasia4 (15.3%), pregnancy3(11.5%), fat necrosis1(3.8%), diabetes3 (11.5%) and breast cancer 2(7.6%). The pattern of culture results was different in the two groups, from differing causative organisms namely staphylococcus aureus as the commonest organism in both groups, in comparison to such uncommon organisms as Klebsiella pneumonae, Peptococcus magnus, Streptococcus group B, Entro-bacter cloacae, Methicillin resistant staphylococcus aureus (MRSA) and Mycobacterium tuberculosis occurring in group II only. Fortunately, all organisms were sensitive to antimicrobial therapy.

CONCLUSION

Breast infection in non-lactating women is an infrequent but recognized clinical entity that deserves special attention. An underlying clinical condition should always be sought and treated. Indeed, in addition to cultures, radiological modalities such as ultrasonographic imaging may provide specific diagnosis and aid the management.

摘要

背景

哺乳期母亲的乳腺感染是一种常见病症,在大多数情况下可由上行性感染解释。然而,人们注意到,出现乳腺脓肿的非哺乳期女性数量正在增加。本研究试图探讨非哺乳期女性乳腺感染的病原体敏感性模式及潜在病因。

材料与方法

本综述于1991年至2003年在沙特阿拉伯胡拜尔法赫德国王大学进行。纳入所有出现乳腺感染的患者。对病历、手术记录、培养结果、组织病理学报告及预后进行回顾。

结果

在6314例有各种乳腺问题的患者中,出现乳腺感染的患者有179例(占3.5%)。136例(76%)哺乳期女性发生感染(第一组),而非哺乳期(第二组)乳腺感染占43例(24%)。年龄范围为24岁至52岁。在第二组的26例患者(60%)中发现了潜在临床病症,即肉芽肿性乳腺炎13例(50%)、导管扩张症4例(15.3%)、妊娠3例(11.5%)、脂肪坏死1例(3.8%)、糖尿病3例(11.5%)和乳腺癌2例(7.6%)。两组的培养结果模式不同,致病病原体也不同,金黄色葡萄球菌在两组中都是最常见的病原体,而肺炎克雷伯菌、巨大消化球菌、B组链球菌、阴沟肠杆菌、耐甲氧西林金黄色葡萄球菌(MRSA)和结核分枝杆菌等不常见病原体仅在第二组中出现。幸运的是,所有病原体对抗菌治疗均敏感。

结论

非哺乳期女性的乳腺感染是一种少见但已被认识的临床病症,值得特别关注。应始终寻找并治疗潜在的临床病症。实际上,除了培养之外,超声成像等影像学检查手段可能有助于提供特异性诊断并辅助治疗。

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