Department of General Ineternal Medicine, Mito Kyodo General Hospital, Mito, Japan.
Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, Japan
BMJ Case Rep. 2022 Nov 29;15(11):e250277. doi: 10.1136/bcr-2022-250277.
We report a case of lactational mastitis complicated by bacteraemia in a breast feeding, healthy woman in her 20s. Numerous investigations showed that mastitis was the probable source of bacteraemia. While is known to cause non-lactational mastitis in patients with underlying diseases, such as systemic lupus erythematosus, reports of lactating mastitis in healthy individuals are scarce, with only six cases reported in the scientific literature published in English since 1995. Similar to previous reports, our patient had a good clinical course with antimicrobial therapy, and the infection was presumably transmitted from the asymptomatic child to the mother. Although the exact mechanisms that establish transmission from a child remain unclear, both host and pathogen factors, such as stagnant milk or bacterial virulence factors, are thought to play a key role. Caution should be exercised because serotypes not currently covered by pneumococcal vaccines are emerging.
我们报告了一例 20 多岁哺乳期健康女性因乳腺炎合并菌血症的病例。大量研究表明,乳腺炎可能是菌血症的来源。虽然众所周知, 会引起患有系统性红斑狼疮等潜在疾病的非哺乳期乳腺炎,但在 1995 年以后发表的英文科学文献中,仅有 6 例报告健康个体发生哺乳期乳腺炎。与以往的报告相似,我们的患者在接受抗菌治疗后临床病程良好,感染可能是由无症状儿童传播给母亲的。尽管目前尚不清楚从儿童传播的确切机制,但宿主和病原体因素,如停滞的乳汁或细菌毒力因子,被认为起着关键作用。由于目前肺炎球菌疫苗未涵盖的血清型正在出现,应谨慎对待。