Abstract

BackgroundLactational breast abscesses are uncommon in the puerperium but when they do develop, delays in specialist referral may occur especially in resource low settings. There is a dearth of studies regarding lactational breast abscesses in Cameroon. We aimed to estimate the incidence of lactational breast abscess and describe its management by percutaneous aspiration at the Douala General Hospital, Cameroon.MethodsWe conducted an observational prospective study of 25 breastfeeding women at the Douala General Hospital from January 1, 2015, to October 31, 2015. Participants were consenting breastfeeding women who completed a baseline questionnaire after diagnosis of lactational breast abscesses and underwent percutaneous needle aspiration under local anaesthesia. Data were analyzed by using descriptive statistics.ResultsThe estimated incidence of lactational breast abscesses was 0.74% (28/3792). The age range of babies at the onset of breast abscess was 4 to 35 weeks; mean 28.3 ± 10.85 weeks. Forty-four per cent of participants underwent three lactational abscess aspirations and in 24 to 28% of them, it took 8 to 9 days for the abscess to resolve. In 72% of participants, treatment was with needle aspiration plus flucloxacillin. Seventy-six per cent of participants continued breastfeeding after abscess treatment.ConclusionThe estimated incidence of lactational breast abscess at the Douala General Hospital is 0.74%. Percutaneous needle aspiration under local anaesthesia is an effective treatment for superficial lactational breast abscesses in most cases with or without ultrasound guidance and should be recommended worldwide as first line treatment. Further research is needed to understand the outcome of local infiltration of antibiotics on the abscess cavity.

Highlights

  • Lactational breast abscesses are uncommon in the puerperium but when they do develop, delays in specialist referral may occur especially in resource low settings

  • This study aimed to estimate the incidence of lactational breast abscess and describe its management by percutaneous aspiration at the Douala General Hospital, Cameroon

  • Data was collected from breastfeeding mothers who gave birth at the Douala General Hospital (DGH) and returned later because of a breast condition and those referred from other health facilities; Laquintinie Hospital Douala (LHD), a secondary care centre with 2750 births annually and Cite Des Palmier District Hospital Douala (CPHD), a primary care centre with 550 births per year

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Summary

Introduction

Lactational breast abscesses are uncommon in the puerperium but when they do develop, delays in specialist referral may occur especially in resource low settings. There is a dearth of studies regarding lactational breast abscesses in Cameroon. We aimed to estimate the incidence of lactational breast abscess and describe its management by percutaneous aspiration at the Douala General Hospital, Cameroon. Lactational breast abscesses are complications of infectious mastitis and are more frequent among primiparous women. It has been estimated that 0.4 and 3% of women with mastitis develop a breast abscess [1]. Mastitis usually occurs during the first 6 weeks but can occur at any time during lactation [2, 3]. The incidence of lactational breast abscesses is reducing over time because of the increasing use of antibiotics and improved breastfeeding practices [3]. Other organisms like Escherichia coli and Haemophilus influenza have been identified [2, 4, 5]

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