How to understand that there is pus coming from the chest. Purulent mastitis: causes and proper treatment

Inflammation in the mammary gland followed by the formation of pus is called purulent mastitis. This disease requires immediate consultation with a doctor, as untimely treatment can have very serious consequences.

Forms

There are two forms of pathology: non-lactation and lactation mastitis. Purulent mastitis, due to stagnation of milk and the entry of pyogenic cocci into the body, usually develops in a nursing mother within a month after childbirth.

The non-lactational form can develop for the following reasons:

• chronic diseases and pathologies;
• injuries of the mammary glands;
• premenstrual period in a woman;
• hypothermia;
• the presence of secondary immunodeficiency.

Note. Purulent mastitis can appear not only in nursing mothers; It is not uncommon for women who have not given birth to suffer from this disease.

Symptoms

Purulent mastitis during breastfeeding is easy to distinguish from milk stagnation. With lactostasis, a woman feels better after she has expressed milk; The mammary gland does not swell or turn red.

In the first stages of mastitis, patients may complain of:

• headache;
• swelling, redness of the breast;
• breast enlargement or swelling;
• asymmetry of the mammary glands (if an acute process develops only on one side);
• soreness at the point of contact;
• increased body and breast temperature (warmth is felt when placing your hand on the sore breast);
• feeling unwell, chills;
• burning sensation during feeding.

Gradually the situation becomes worse, and the following symptoms of purulent mastitis appear:

• temperature rise to 39 degrees;
• enlarged lymph nodes in the armpits;
• there may be purulent discharge from the nipple;
• chest pain increases;
• the sore breast turns red and hardens.

Causes

The causative agents of this disease are Staphylococcus aureus, Enterobacteriaceae or Pseudomonas aeruginosa. Infection can enter through cracks or sores in the nipples.

Important! The main provoking factor of mastitis is lactostasis. If it is not treated, then literally in three to four days the process of pus formation may begin.

The causes of purulent lactation mastitis can be:

• improper attachment of the baby to the breast;
• accumulation of milk in the ducts;
• improper pumping;
• cracks and wounds on the nipples;
• improper cessation of breastfeeding;
• mastopathy.

Important! In case of mastitis, under no circumstances should you heat the mammary glands and squeeze out the pus yourself.

Stages

In its process, purulent lactation mastitis usually goes through the following stages:

1. Serous (initial) - characterized by a sharp increase in temperature to 38 degrees. There is also a feeling of heaviness in the sore chest, pain at the site of inflammation. The skin in this area may turn red; expressing milk becomes difficult.
2. At the infiltrative stage, a painful compaction forms, which is easily felt by palpation. The infiltrative stage of purulent mastitis is dangerous because it can develop into an abscess form.

The beginning of the development of an abscess is indicated by the appearance of a compaction, the boundaries of which are clearly defined, and softening is palpable in the middle. In the infiltrate, several small abscesses may form at once.

If the disease is not treated, it will develop into acute purulent mastitis. It is characterized by deterioration of the patient's condition and a sharp increase in temperature. This is the phlegmonous stage of the disease. The breasts become bluish and swell. Because of this, the nipple may be pulled inward.

An advanced disease can develop into gangrene (gangrenous stage). Black spots and epidermal blisters with bloody fluid inside appear on the skin. The chest may be purple in color. At this stage, the process of damage to the entire mammary gland occurs. In acute mastitis, pus may be present in the milk.

Important! When an infection joins lactostasis, fermentation and coagulation of milk begins in the ducts, which is fertile ground for the proliferation of microbes and the appearance of pus.

Diagnostics

At the first suspicion of mastitis, you should immediately contact the clinic. The doctor will conduct an examination and prescribe the necessary examination.

After examination by a specialist, a woman is usually prescribed blood tests (general and sugar), urine tests, and ultrasound. Ultrasound examination allows you to determine the location of accumulation of pus, the size of the lesions, and also perform a puncture to take material for bacteriological examination.

Treatment

Conservative treatment

This treatment for purulent mastitis is prescribed to the patient in the first stages (lactostasis, serous mastitis). It involves expressing milk every three hours and antibiotic therapy. To relieve pain when pumping, a woman may be prescribed antispasmodics. The doctor may prescribe UHF therapy, semi-alcohol wraps and compresses to the patient.

Surgical treatment

If conservative treatment of purulent mastitis is ineffective, then surgery is performed. It involves opening and draining the inflammation site under general anesthesia. The sooner surgery is performed, the lower the risk of complications.

After surgical treatment purulent mastitis, the woman is given a course of antibacterial therapy. If the inflammation is stopped and milk tests for bacteria are negative, then after treatment the woman can continue to breastfeed her baby.

Important! Timely consultation with a doctor will help to avoid possible complications purulent mastitis and will increase the chances of avoiding surgery.

There is no need to breastfeed a child with purulent mastitis, i.e. The baby should not be put to the breast. A nursing mother herself expresses milk from both mammary glands. The baby is given milk from a healthy breast (from a bottle), having previously been pasteurized.

Complications

Complications of purulent mastitis can develop during the disease itself or after surgery. The first include development acute forms inflammation (gangrene and phlegmon of the mammary gland). They are dangerous because they can provoke the development of sepsis.

It is possible to develop a milk fistula in the period after surgery. This is not a contraindication to breastfeeding. The fistula closes within three months. After surgery, the wound may become suppurated and the disease may recur. Sometimes a cosmetic defect remains on the chest after surgery for purulent mastitis.

Women need to monitor their breasts and contact specialists at the first manifestations of mastitis. This will help solve the problem without surgery.

The appearance of discharge from the nipples should alert a woman. Breast discharge may occur as a result of natural physiological processes, but may be a sign various diseases. It is of great importance what color and consistency they are, whether there are any additional complaints, and the woman’s age. Early detection of breast diseases is important for cure. Therefore, the appearance of discharge cannot be ignored, especially if there is a change in the shape or size of the glands. Only a doctor can determine whether there is cause for concern in this case.

Content:

Causes of breast discharge

In some cases, the appearance of clear discharge from the mammary glands is considered normal. Milk production occurs in the alveoli located in the lobules of the mammary gland. The milk ducts carry it from the lobules to the nipple. In the absence of lactation, the ducts are filled with fluid, which can be released out only in isolated cases, for example, before menstruation, when the gland is tense and swollen, during sexual intercourse or in case of strong pressure on the breast.

The appearance of colostrum (a clear, yellowish liquid) occurs during pregnancy when the mammary gland swells before milk production begins.

Unusual is the appearance of milky discharge that is not associated with breastfeeding, a change in color and an increase in the intensity of fluid formation. The occurrence in one or both glands should also attract attention. pain simultaneously with discharge from the nipples, an increase in body temperature.

Causes of unusual discharge may include:

1. hormonal disorders associated with diseases thyroid gland, adrenal glands, ovaries, brain tumors;
2. taking hormonal contraceptives;
3. treatment of any diseases using hormonal drugs;
4. taking some others medicines, for example, antidepressants;
5. benign or malignant tumors of the mammary glands;
6. squeezing by tight underwear;
7. chest injuries.

Types of discharge

The color of the discharge can suggest the cause of the anomaly. The diagnosis is clarified through additional examination.

White

Volume and shades (from white to light brown) may vary. They appear in the form of several drops as a result of strong compression of the mammary gland, since there is always liquid in the ducts, which prevents the walls from sticking together and blocking the ducts.

After stopping breastfeeding, milk discharge continues for several months with a gradually decreasing intensity. This is a natural process. If the volume does not decrease and the discharge persists for more than six months, then you should consult a doctor, as this may be a symptom of pathology.

White discharge from the glands also occurs in the presence of diseases associated with hormonal disorders and increased prolactin levels. Milky white fluid is released from the nipples after an artificial termination of pregnancy. This is also due to hormonal changes in the body.

Purulent

Such discharge may be a symptom of an abscess, a purulent process inside the ducts. Abscess requires emergency treatment using antibiotics and special compresses. In some cases, it is necessary to open the inflammation to clear the pus.

Bloody

The appearance of such discharge from the mammary glands may indicate a benign or malignant neoplasm, which involves small vessels located in the glandular tissue.

Dark green

They appear as a result of inflammation of the milk ducts, which are filled with a thick black-green liquid.

Nipple discharge during pregnancy

During pregnancy, changes in the ratio of hormones occur in a woman’s body; prolactin begins to predominate, stimulating milk production. The breasts swell and the milk ducts expand. Even slight stimulation of the nipples increases fluid secretion. Gradually it thickens, and by the end of pregnancy it turns into colostrum, a thick yellowish mass, sweetish in taste and nutritionally superior to breast milk. For some women, colostrum appears immediately after childbirth, while for others it appears later in pregnancy. The time of appearance of colostrum does not affect subsequent lactation.

Recommendation: There is an opinion that if you express colostrum, there will be more milk later. In fact, this has no effect on lactation, but nipple stimulation can cause uterine contractions. A miscarriage may occur.

Diseases that cause discharge from the breast

Most breast diseases in women occur against the background of hormonal imbalances that occur as a result of age-related changes or disruption of the functioning of other organs.

Galactorrhea

The intensity and duration of lactation is regulated by the hormone prolactin, which is produced in the pituitary gland. Galactorrhea is an abnormal milk production that does not stop 5-6 months after the baby is weaned and is associated with an excess level of this hormone in the body. Elevated prolactin levels are typical for women aged 45-50 years. The cause of an abnormal increase in the level of the hormone can be head injuries, brain tumors, diseases of the ovaries, adrenal glands or thyroid gland, liver.

Galactorrhea can occur due to stress experienced by a woman. There is the concept of "idiopathic galactorrhea", that is, the release of milk for no apparent reason. As a rule, this disease is accompanied by a violation of the menstrual cycle, a decrease in libido. Signs of increased prolactin are also growth of facial hair.

Video: Causes and manifestations of hyperprolactinemia

Ectasia of the milk ducts

This is an inflammatory disease of the milk ducts, which is characterized by the appearance of black-green discharge from the mammary glands. Usually the cause is hormonal changes that occur at the beginning of menopause. This disease is treated with anti-inflammatory and antibacterial agents. Sometimes carried out surgical removal affected area.

Video: What is milk duct ectasia

Intraductal papilloma

A benign disease associated with the appearance of growths on the walls of the ducts, spreading to the nipple area. It is dangerous because cells of damaged glandular tissue may degenerate and cancer may occur. The discharge from the nipples is thick and mixed with blood. It is more common in women after 35 years of age.

Mastitis

Abscess, purulent inflammation that most often occurs in nursing women. The cause is cracks that appear on the nipples due to damage to the delicate tissue when the baby sucks milk. In this case, an infection enters the milk ducts. Suppuration of the ducts is accompanied by an increase in the size of the gland, redness, increased temperature, and the appearance of pus in the milk. In this case, breastfeeding is stopped completely, treatment is carried out with antibiotics or the milk duct is opened to remove pus.

Mastopathy

A benign disease that occurs due to the proliferation of breast tissue (glandular and connective). Yellowish or transparent bloody issues with mastopathy they appear in the second phase of the menstrual cycle. They disappear when menstruation occurs. The appearance of fluid from the nipples is accompanied by pain in the mammary glands. For treatment, drugs are prescribed that restore the normal ratio of hormones in the blood. Large nodes formed during mastopathy are removed surgically.

breast cancer

The discharge may be bloody, clear or thick. In this case, the nipple is retracted due to swelling. Dense areas with jagged edges are felt in the chest. They grow together with the skin, which takes on the appearance of a lemon peel. More often, discharge appears in one breast affected by the tumor.

Examination for unusual nipple discharge

When any unusual discharge from the mammary glands appears, an examination by a gynecologist, mammologist, endocrinologist, oncologist is necessary to determine their cause and timely diagnosis of the disease.

The examination usually consists of external examination and palpation of the breast, mammography, ultrasound, blood tests. The examination is carried out in order to detect tumors and determine their nature, as well as to determine the level of hormones in the blood.

Inflammation mammary gland(mastitis) occurs acutely and chronically. In the postpartum period, as well as during the entire period of breastfeeding, acute lactational mastitis develops. Women who do not breastfeed sometimes develop non-lactating mastitis, but less frequently.

Reasons for the development of lactation mastitis

• frequent development of stagnation of milk in the breast (lactostasis), especially in the postpartum period;
• decreased immunity in pregnant women due to hormonal changes and after childbirth due to stress and blood loss;
• the appearance of microcracks and abrasions on the nipples - a gateway for infection;
• structural features of the milk ducts and nipples, the functioning of the mammary gland;
• failure by a woman to comply with hygienic rules for caring for the mammary glands.

Most often, inflammation develops due to a complex of reasons. The causative agents of the infection are representatives of opportunistic microflora that constantly live on human skin: staphylococci, streptococci, E. coli, etc. With normal immunity, these pathogens do not cause disease, but in a woman in the postpartum period, immunity is reduced, this is the reason for the onset of infection.

There are also hospital forms of the disease, in which the infection is transmitted through contact by persons who are carriers of the infection. Hospital forms of mastitis are more severe and less treatable.

Why do cracked nipples appear?

Cracks and abrasions of the nipples are of great importance in the development of inflammation. The reasons for their formation are:

• functional inferiority of the nipples and areola;
• malformations of the nipples - flat, inverted, large, small, grape-shaped;
• prolonged exposure to the child’s mouth and maceration (soaking);
• the child grasps only the nipple without the areola;
• insufficient milk, which creates significant negative pressure in the baby’s mouth and disrupts the integrity of the tissues;
• too much milk - overstretching of the nipple area occurs, which leads to tissue injury.

Types of cracks: superficial, deep and circular (located at the border of the nipple and areola). The formation of cracks occurs in three stages: catarrhal inflammatory process and maceration (soaking), crust and erosion. Prevention and treatment of cracks is the main prevention of inflammatory processes in the mammary gland.

Important information! A nursing mother needs to promptly treat abrasions and cracked nipples and follow the rules for caring for the mammary glands.

What happens in the body of a woman suffering from purulent mastitis?

The process most often begins with stagnation in the mammary gland - lactostasis. This happens due to narrow milk ducts in first-time mothers, disruption of the integrity and functions of the gland tissue, etc. The infection enters the breast through microtraumas of the skin or through the openings of the milk ducts.

The penetration of infection is accompanied by curdling of milk in the milk ducts, their walls swell, their internal layers (epithelium) are damaged, and become permeable to infection. Inflammation, swelling and pain develop in the chest.

Symptoms and signs of the disease

Symptoms of inflammation must be distinguished from symptoms of lactostasis. With lactostasis, swelling occurs without redness of the skin and fever (there may be a slight low-grade fever), there is no pain, relief occurs after pumping.

When acute inflammation begins, a red spot appears on the skin of the chest, the size of which depends on the size of the forming infiltrate. The breasts become painful, pumping no longer brings relief. Sometimes it is impossible to express the breast from the first days of mastitis development due to severe pain. The transition of lactostasis to inflammation begins with severe fever and chills. The breasts become swollen and painful, and redness appears on the skin. Palpation reveals unclear areas of hardening.

On days 2–3, serous inflammation becomes infiltrative. Body temperature rises to maximum levels, health worsens, chest pain increases. A clear red spot appears on the skin, and an infiltrate can be felt under the skin.

On days 4–5 from the onset of the disease, the infiltrative process becomes purulent. The affected breast shows signs of liquid pus. In this case, the temperature is either constantly high, or takes on a hectic character (it rises sharply, then drops just as sharply). Nearby (axillary) lymph nodes become enlarged.

The gangrenous process is especially difficult. The chest swells sharply, the skin above it turns blue and becomes covered with blisters containing brown liquid. Dying tissue is visible. Swelling takes over everything soft fabrics chest.

Important tip! At the first signs of mastitis, you should immediately consult a doctor.

Features of the course of purulent mastitis in the postpartum period and during breastfeeding

After childbirth, the disease begins approximately 5–7 days and is acute with a rapid transition from one phase to another. IN last years There is an increasingly frequent development of delayed forms of this process in the postpartum period. Such inflammation may not begin immediately, but at 3–4 weeks.

Treatment and help at home

Treatment should be started as early as possible. It is better when lactostasis has not yet turned into an inflammatory process. Prescribe breast rest (an elevated position supported by special bandages or a bra), frequent feeding of the newborn with expressing milk in the shower or using a breast pump. But it is believed that hand expression is more effective.

In the postpartum period, after each feeding, the nipples and areolas must be examined. If cracks and abrasions appear, the mammary gland is washed with boiled water and soap, treated with alcohol and antiseptic ointment is applied (Levomekol ointment is approved for use during pregnancy). This is a combination ointment that contains the antibiotic chloramphenicol and the immunostimulating and regeneration-accelerating agent methyluracil. To relieve inflammation, the nipple is lubricated with Vinilin, and Solcoseryl ointment is used to regenerate nipple tissue.

If the onset of serous or infiltrative inflammation is suspected, bed rest is prescribed, lying on the back or on the healthy side. Cold is applied to the mammary gland. This causes constriction blood vessels, reduces blood supply to the breast, inhibits metabolic processes in it and milk secretion, relieves swelling and pain.

Cold is used for 1 – 2 days until body temperature normalizes. After this, physiotherapeutic procedures are carried out (Ural irradiation, UHF, etc.). A woman continues to breastfeed her newborn.

Treatment in hospital

If purulent inflammation begins, the woman is hospitalized. Experts have different views on feeding a child with purulent mastitis, but most doctors believe that during the period of pus excretion with milk, it is better to stop feeding the newborn, but continue expressing milk.

Small abscesses are sometimes treated conservatively by puncturing the mammary gland under ultrasound guidance, pumping out the pus and rinsing the cavity with antibacterial solutions. At the same time, antibacterial therapy is prescribed.

The main method of treating purulent processes is surgery. The abscess is opened, washed with antiseptic solutions, and then treated as open wound. Antibacterial therapy is required.

Purulent mastitis: stages of development of the inflammatory process, forms depending on etiological factor occurrence of the disease, symptomatic signs, conservative and surgical treatment methods.

What it is

Purulent mastitis is an inflammatory disease that is characterized by purulent infiltration of breast tissue. Most often, an abscess develops in women during lactation with prolonged or improper feeding.

Causes

Acute purulent mastitis develops as a result of infection of the glandular ducts with a bacterial pathogen (the most common is Staphylococcus aureus). Infection occurs when staphylococcus enters through cracks in the halo and spreads through the mouths of the internal thoracic ducts.

Provoking factors for the accumulation of pus in the mammary gland include:

• improper breastfeeding;
• accumulation of milk residues in the lobular ducts of the mammary gland;
• improper pumping process;
• formation of cracks in the nipples during feeding or due to mechanical trauma;
• anatomical features of the structure of the mammary gland;
• prolonged stagnation of milk residues in the thoracic ducts.

In addition to the above etiological factors, surgical interventions for artificial breast implantation and benign oncological processes can also trigger the development of the disease.

Stages and symptoms of the disease

The inflammatory process with the accumulation of pus in the mammary gland progresses gradually, starting with an increase in general body temperature and localized soreness in the mammary gland.

Depending on the stage of progression, purulent mastitis is divided into:

1. serous stage begins with discomfort and increased body temperature. Over time, the gland begins to enlarge with pronounced swelling. An area of ​​hyperemia forms above the location of the inflammatory focus. During palpation, pain of low intensity in a diffuse localization appears.
2. stage of infiltration. With infiltrating purulent mastitis, the symptoms are the same as with the serous form, but palpation reveals a compaction of glandular tissue that does not have clear boundaries.
3. With the development of the purulent stage signs of general intoxication syndrome appear in the form of nausea, vomiting, complete lack of appetite and deterioration in the woman’s general well-being. When conducting laboratory diagnostics peripheral blood parameters change, which indicates the presence of an inflammatory process. Characteristic changes pain syndrome, the pain becomes diffuse in nature, radiating to the area of ​​the upper limb on the side of the affected gland. On palpation, a clearly limited compaction is felt, which causes sharp pain when pressed. At this stage of the disease, pus in the mammary gland continues to accumulate due to the intensive proliferation of the bacterial pathogen.
4. Phlegmonous stage manifests itself in the form of an increase in symptoms of intoxication and an increase in general and local body temperature. The skin over the abscess area becomes bluish with pronounced swelling. The swelling of the soft tissues is so severe that the halo is retracted into the gland.
5. gangrenous stage– this is an extremely advanced condition, which is characterized by the appearance of an area of ​​necrosis of glandular tissue with further spread of the pathological process.

Depending on the location of the inflammatory focus, purulent mastitis is divided into the following types:

• subareolar;
• intramammary;
• retromammary;
• total.

Forms of mastitis depending on the cause

The implementation of therapeutic and preventive measures depends entirely on the form in which the infectious-purulent process occurs. Every woman should independently examine the mammary gland and, at the slightest suspicion, seek qualified help.

Today, depending on the etiological factor, purulent mastitis is usually divided into three large forms: lactation, non-lactation and purulent.

Purulent mastitis of lactation origin

Lactation mastitis is the most common form of abscess formation in breast tissue. A large percentage of morbidity is observed in women who have given birth to a child for the first time and are not fully familiar with the procedure of feeding a child. The immediate cause of the accumulation of pus is the stagnation of milk residues in the thoracic ducts after inadequate pumping.

The main symptoms of lactation purulent mastitis include:

• bursting pain without clear localization;
• area of ​​hyperemia over the affected area;
• increase in the volume of the mammary gland;
• febrile syndrome.

The difference between the non-lactation form of the disease is that the symptoms appear with less pronounced intensity or their complete absence.

The main predisposing factors for the development of a purulent process include:

• traumatic effects on the chest area;
• mastopathy;
• oncological diseases;
• infectious processes of specific origin - tuberculosis, mycoses.

Non-lactation purulent mastitis with chronic course

The chronic course of the disease develops due to improper implementation of therapeutic measures in acute cases. inflammatory disease. During the period of remission, the woman feels well, there are no symptoms of inflammation, but when the disease relapses, the clinic is characterized by an acute inflammatory process.

Diagnostics

Purulent mastitis does not present any difficulties in diagnosis. In order to make a final diagnosis, laboratory and instrumental diagnostics of the disease are performed. Based on the results of a laboratory study of peripheral blood, the presence of an inflammatory process in the body is judged, this is indicated by an increase in the erythrocyte sedimentation rate and an increase in the number of leukocyte cells.

When conducting ultrasound examination of the mammary gland, the amount of accumulated pus and its exact location are determined. Under ultrasound control, a biopsy of the abscess contents is performed to determine the species of the bacterial pathogen.

Treatment methods

For purulent mastitis, treatment should be timely and comprehensive, including surgical and conservative therapy. A conservative treatment method without surgical intervention is carried out only if the disease is in the serous stage without accumulation of pus in the glandular ducts.

Conservative

Conservative treatment should be carried out only in the first days of the disease, no later than five days. Before starting treatment with medications, it is necessary to ensure rest for the mammary gland and regularly express milk.

The main and widely used drugs include:

• oxytocin 0.5 ml IV, to reduce milk production by the mammary glands;
• solution of platifilin 2% IM or diclofenac 5 ml to relieve pain;
• solution of trypsin or chymotrypsin 10 mg in combination with novocaine 0.5% for retromammary blockade;
• a solution of ceftriaxone 1.0 to 10.0 sodium chloride intravenously in a bolus to eliminate the bacterial pathogen.

To improve the pharmacokinetic properties of drugs and improve general microcirculation in a woman’s body, physiotherapeutic procedures are used, which include:

• exposure to ultrasonic radiation at the site of damage;
• phonopheresis with the addition of enzymatic preparations;
• exposure to x-rays.

In the complete absence of positive dynamics in the patient, surgical intervention is indicated.

Surgical

The surgical method of treating a purulent disease is considered the fastest and most effective; this is due to the massive accumulation of pus in the glandular tissue. For purulent mastitis, the operation can be carried out in the form of a puncture puncture of the abscess cavity, followed by suction of the purulent contents.

If there are many pustules or abscess big size the surgeon makes several incisions throughout the inflammatory focus, extracts pus from the wound, rinses the abscess cavity with antiseptic solutions and installs passive drainage to drain the remaining pus.

Possible complications

Complications can develop as follows: postoperative period, and due to incorrect or ineffective conservative treatment.

Complications of purulent mastitis include:

• phlegmon and gangrene of the glandular structures of the mammary gland;
• fistula formation;
• increased risk of disease relapse due to postoperative scarring of the excretory ducts;
• anatomical defect;
• general blood poisoning.

Preventive actions

Prevention of inflammatory and purulent diseases of the mammary gland involves the following measures:

1. Stick to correct mode food with a specially selected daily diet.
2. Carry out hygienic measures to care for the mammary gland, especially during lactation.
3. Carefully read the rules of breastfeeding.
4. Avoid traumatic exposure.
5. After each feeding, mechanically express milk.

Every woman needs to conduct an independent examination of the mammary glands, palpate the mammary glands and regional lymph nodes. The self-examination procedure is carried out by palpating the mammary glands in a circular motion. If you notice an area of ​​compaction or tenderness, you should seek medical help.

Video

You will learn more about the symptoms and treatment of mastitis in our video.

The health of a woman's breasts is important not only for maintaining her beauty and sexuality. Raising a healthy baby without mother's milk is extremely costly and problematic. No ultra-modern milk formulas can compare with it in terms of benefits.

That is why every woman is obliged to closely monitor the condition of the mammary glands, paying attention to the slightest alarming changes in their condition. One of the dangerous signs indicating the development of a serious pathology is purulent discharge (PD) from the chest. There may be several reasons for their appearance - all of them are dangerous not only for women’s health, but also for general condition organism.

Any discharge from the nipple, if it is not directly related to lactation, is a rather dangerous symptom. It should alert any woman and encourage her to see a mammologist.

Liquids that may flow out of the nipple may vary in color (yellowish, transparent), consistency (sticky, watery), and smell. It depends on the nature of the flow in the mammary gland pathological changes. The discharge can separate when pressed or flow out spontaneously.

Inflammatory diseases of the mammary glands are common today. One of their main manifestations is chest pain and purulent discharge from the nipple. To know what this entails, you need to have an idea of ​​the nature of this phenomenon.

Purulent discharge (PU) from a woman’s breast - what is it?

Pus is a cloudy exudate that accumulates in the affected tissues during the progression of a purulent/seropurulent inflammatory process. The exudate contains: purulent serum, tissue detritus, living\degenerated cells of microorganisms or neutrophilic leukocytes.

The color of pus can be different - dirty gray, bright green, bluish, yellow, yellow-green. Often still present bad smell. It depends on the reasons for the formation of suppuration. The exudate always includes pathological microorganisms that lead to the emergence and progression of the inflammatory process - streptococci, gonococci, staphylococci, meningococci, putrefactive anaerobic clostridia and others.

Why does pus come from the chest - causes of purulent discharge

Pus does not just form in the chest. Its accumulation and further release is always preceded by a pathological inflammatory process of the mammary glands, accompanied by painful changes. Pus from the chest during breastfeeding is released against the background of the following symptoms:

• itching and burning in the chest;
• swelling;
• sensations of discomfort, bloating;
• soreness;
• redness of the skin of the gland, increased local (sometimes general) temperature.

Pus may be released from the nipples when pressing on the chest. Exudate can also come out spontaneously if a lot of it accumulates.

Pus in the mammary gland in a woman can be a symptom of the following diseases or conditions:

• purulent cyst;
• other benign\malignant formations;
• infection of nipple tissue when it is damaged;
• infection of the gland after surgery on it;
• carbuncles\furuncles on the skin of the mammary gland.

Question: Hello. My name is Valeria, I am 30 years old. I discovered a painful lump on my chest. It was hot to the touch and red. The doctor said it was purulent atheroma of the mammary gland. Tell me, is this very dangerous?

Answer: Hello. Atheroma itself is a benign neoplasm. In your case, the danger lies in its inflammation and suppuration. Required mandatory operation for removal in order to avoid complications. Don't delay this.

Purulent mastitis

Purulent mastitis is one of the most common reasons causing purulent discharge from the chest. This is an inflammatory pathology of mammary gland tissue, most often diagnosed in breastfeeding women 3-4 weeks after the birth of the baby.

Depending on the causes, there are two types of purulent mastitis:

• Lactation;
• Non-lactational.

Lactation develops in postpartum period, usually two to three weeks after birth, sometimes after 10 months. Most often observed in primiparous women.

The main causative agent of the disease is Staphylococcus aureus, which penetrates into the tissue of the mammary glands through cracks in the nipples, then through the mouths of the milk ducts. In order for the inflammatory process to develop, two pathological factors must be present - the presence of infection and lactostasis (milk stasis). Moreover, the latter acts as a trigger for the progression of purulent mastitis and is considered main reason its development.

Lactostasis can occur due to:

• non-compliance with feeding regimen;
• insufficient/irregular expression of milk;
• violations of the pumping technique - rough squeezing of milk, causing a closed injury to the gland;
• cracks in the nipples, nipple stiffness;
• genetic changes in the mammary gland - convoluted thin milk ducts;
• previous surgical interventions on the chest.

Stagnation of milk during lactation leads to its coagulation and the development of the process of lactic acid fermentation, which further worsens the outflow. The products of lactic fermentation are an ideal environment for the vital activity of pathogens penetrating the gland, causing a rapid transition of the inflammatory process to the purulent stage.

Non-lactation mastitis is inflammation of the mammary gland in non-lactating women. Its reasons may be:

• chest injuries;
• implantation of foreign bodies into the mammary gland;
• suppuration of malignant/benign breast tumors;
• advanced purulent diseases of the skin / subcutaneous tissue (furuncle, carbuncle on the skin of the chest), when pathological process passes into deeper tissues.

The range of pathogens causing non-lactation mastitis is much wider. It can be caused by Staphylococcus aureus or epidermidis, enterobacteria, Pseudomonas aeruginosa.

Question: Good afternoon. My name is Maria. I am 33 years old. Recently I fell hard. Yesterday I felt pain in my chest. When feeling, she found that there were seals, and a little bit of pus was squeezed out of the nipple. Tell me why I have lumps and pus in my chest?

Answer. Hello Maria. All your symptoms indicate that a non-lactational form of mastitis is developing. The reason in this case is most likely the trauma of the mammary gland received before. Urgently contact a mammologist, an accurate diagnosis can only be made after a complete examination.

Symptoms for lactational and non-lactational purulent mastitis are largely similar. The following clinical picture is observed:

• The mammary gland greatly increases in size. In this case, the pathological process most often affects one mammary gland, the breast looks asymmetrical.
• The local temperature rises – you can feel it to the touch. The progression of the process causes general hypothermia - the temperature can rise to 38°.
• The following signs characteristic of inflammation are recorded: local pain that intensifies when touched, redness at the site of the skin lesion.
• Regional The lymph nodes(chest, axillary) increase - this can be detected by palpation.
• The primary focus, through which pathogens enter the milk ducts, becomes noticeable after a few days. It looks like an abscess - a yellow-green center, fuzzy contours, reddened skin around it.
• Lumps and lumps can be felt in the affected breast. When you press on the gland, purulent discharge comes out of the nipple.

Developing lactation purulent mastitis leads to difficulty in the passage of milk, sometimes it may stop being released completely - this process is accompanied by very severe pain. At lactation mastitis milk with pus may come out, so breast-feeding Absolutely forbidden.

Question: Hello. My daughter is 25 years old. Three weeks ago she gave birth to a girl and is now breastfeeding. Yesterday we noticed something very reminiscent of pus in the milk, one breast was inflamed and hurt. Tell me, where did the pus in the chest come from after childbirth?

Answer: Hello. Your daughter has all the symptoms of lactation mastitis. Stop breastfeeding immediately and run to the doctor!

Purulent breast cyst

A breast cyst is a benign cavity filled with liquid contents that develops in the tissues of the mammary gland (most often in the milk ducts). For a long time the cyst does not manifest itself in any way. Only as pathologies progress can they appear: a burning sensation in the chest, deformation of the mammary gland, and a change in the color of the skin at the site of the lesion. The main cause is hormonal imbalance.

Sometimes, if there are pockets of bacterial/viral lesions in the body, pathogenic microorganisms can penetrate through the bloodstream into the breast tissue, causing inflammation and suppuration of the cyst. The following factors can increase the risk of developing purulent inflammation of the tumor:

• “poor” functioning of the immune system;
• mechanical injuries of the mammary gland;
• long-term exposure to various heat sources (warm compresses, bath/sauna, sunbathing);
• squeezing the chest with tight, uncomfortable underwear;
• constant stress;
• hypothermia;
• alcohol abuse;
• non-compliance with hygiene rules and lactostasis during breastfeeding.

The clinical picture indicating the development of a purulent inflammatory process is as follows:

• very severe pain not associated with menstruation in the area where the cyst is located - often it is pulsating in nature, and can even radiate to the neck, shoulder blade, and sometimes to the arm;
• sharp pain on palpation;
• when a large amount of pus accumulates, it can flow from the nipple, sometimes pus with blood from the chest is observed;
• fever develops - the temperature can rise to 38-39 degrees. As a result, intoxication develops - weakness\general malaise, nausea\vomiting, and loss of appetite are observed;
• the skin over the cyst swells, turns red, and the local temperature rises.

To accurately determine the nature of the inflammation, a puncture is performed, during which fluid is taken from the cyst for cytological examination. This helps to find out whether there is a risk of the cyst degenerating into a malignant neoplasm. After all, the presence of an inflammatory process always increases the possibility of degeneration.

Question: Good afternoon. I was diagnosed. They did various tests and pus was discovered during a puncture of the mammary gland. The doctor said that surgery was needed. Tell me, is it necessary to carry it out?

Answer: Hello. In your case, surgical intervention is simply necessary; delaying it is strictly not recommended. The accumulation of a large amount of pus in the cystic cavity often leads to melting of the cyst walls. Pus will penetrate into the breast tissue, and a dangerous complication will develop - phlegmonous mastitis.

A lump with pus on the chest - carbuncle, furuncle, atheroma

Sometimes (rather rarely) purulent discharge from the nipples can be caused by carbuncles. They are red pustules that rise above the skin, and when subjected to mechanical stress, a woman experiences severe pain. This happens when these bumps with pus develop on the nipples. If the purulent exudate does not find another way out, it can exit through the milky tubules.

The skin of the breast may be affected by an epidermal cyst (atheroma). A neoplasm is formed as a result of blockage of the sebaceous glands, which differ on the skin of the mammary glands increased activity. If the excretion of sebum is impaired, a cystic cavity is formed containing a putty-like mass inside. Atheroma does not pose a particular danger to breast health; this tumor is always benign.

However, if it is large, a woman may experience discomfort and discomfort. Especially unpleasant symptoms develop with inflammation and suppuration of an epidermal cyst:

• there is pain when touched;
• the skin around it swells, changes color (turns red or blue);
• pus and blood are released from the neoplasm.

What to do if pus comes from your chest

The discharge of purulent exudate from the nipples is a very alarming sign. You should immediately contact a mammologist. The doctor will determine how to treat purulent discharge only after a complete examination. An initial examination will be carried out and a number of necessary diagnostic procedures will be prescribed:

• blood analysis;
• ductography and others.

Accordingly, treatment will depend on the causes of suppuration. It may be exclusively medicinal, or it may also require surgical intervention. To stop the inflammatory process, various antiseptic and anti-inflammatory drugs are prescribed. If pus and inflammation are caused by a bacterial infection, antibiotics are required. Sometimes hormonal drugs are prescribed.

Surgical intervention is performed for purulent mastitis to open the ulcers and remove their contents. Surgery often prescribed for the development of purulent inflammation cystic formations mammary gland.

Lactation purulent mastitis causes a nursing woman to develop pus in her milk. In this case, breastfeeding is immediately stopped and immediately consult a specialist.

Question: Hello. I'm Anna, I'm 35 years old. A few days ago I felt that my chest hurt. And when you press on it, something similar to pus does not pour out much from the nipple. Tell me, is this dangerous? Why do I pus is coming from the nipple and your chest hurts?

Answer: Good afternoon Anna. The symptoms you described may indicate the presence of two pathologies - non-lactation mastitis or an inflammatory process and suppuration of the cyst. These conditions are quite dangerous, so immediately consult a mammologist. An accurate diagnosis can only be made after a complete examination.

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