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Breast abscess, vs congestion Mastitis vs infectious mastitis

Discussion in 'Step II' started by surgicel, Sep 24, 2014.

  1. surgicel

    surgicel 2+ Year Member

    Jul 18, 2013
    Quick question is congestion Mastitis the same thing as infectious mastitis or are they two different processes, like breast abscess, can someone tell me how to differentiate based on day of fever

    Congestion Mastitis
    Bilateral, fever day 3,

    Breast abscess,
    Mass, fever weeks later, I AND D

    Infection mastitis
    Fever day 14 , unilateral breast swollen TX is antibiotics

    Is that right, please correct me if they are not 3 different things
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  3. Phloston

    Phloston Physician Lifetime Donor Classifieds Approved 5+ Year Member

    Jan 17, 2012
    Osaka, Japan
    I've never heard of distinguishing between them like that. But yet again I haven't had my obgyn rotation yet.

    I would think the presentations can be variable and it's not something you can peg like you're trying to do.

    The USMLE just wants you to distinguish between mastitis, Paget disease of breast, and inflammatory carcinoma, which can all be kind of similar, but they'll tell you enough that it will be obvious.
  4. thehundredthone

    thehundredthone 5+ Year Member

    Aug 20, 2012
    Though all three will present with fever, breast engorgement doesn't typically have an infectious >101 F type of fever.

    A breast abscess can have fever as the mass develops, there's no reason for it to lag behind the development of a palpable mass.

    I don't know what you mean by day 14, but if you mean puerperium, then it can occur any time in those 6 weeks. (Lactation mastitis is a cellulitis of the interlobular connective tissue within the mammary gland that usually occurs in the first 6 weeks postpartum)

    You're otherwise generally on the mark. The difference between engorgement and full blown mastitis is generally the temperature and the severity. One is treated by breast feeding and symptomatic care while the other requires antibiotics in addition to everything. An abscess is a palpable mass requiring I&D.

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