Nonpuerperal mastitis

Abstract

The medical history of 37 women with nonpuerperal mastitis, who had been treated between January 1980 and July 1983 at the Dept. of Obstetrics and Gynaecology of the University of Tübingen, was reviewed because of the increasing prevalence of this disease. Defined by different history and clinical symptoms, two groups of patients were seen: 25 women with acute nonpuerperal mastitis and 12 women with chronic recurring nonpuerperal mastitis. The average age of the patients was 30 years. The inflammation was located mostly subareolar and around the nipple. The main symptoms were pain, erythema and swelling, in acute cases accompanied by fever and abscess formation. This process was strongly related to the interval between the onset of symptoms and the initiation of treatment. Anaerobes and Staphylococcus aureus could be cultured mainly from women with acute nonpuerperal mastitis. In females with chronic recurrent mastitis, mostly anaerobes were found. Women were treated with a prolactin inhibitor (bromocriptine), if abscess formation, leukocytosis or fever were absent. In patients with leukocytosis and/or fever this regimen was combined with antibiotics. Abscesses were treated surgically, in some cases in combination with prolactin inhibition and antibiotic administration. The results show that an early conservative treatment is important to prevent abscess formation. It seems that this treatment can reduce the rate of recurrences.