Sonographic features of neonatal mastitis and breast abscess
ABSTRACT Neonatal mastitis and neonatal breast abscess are uncommon. Although well described in the pediatric and surgical literature, there is a paucity of reports describing their sonographic features.
To describe and illustrate the sonographic features of neonatal mastitis and neonatal breast abscess.
We reviewed the medical database of a large children's health-care center from 2000 through 2008 for patients presenting in the first 8 weeks of life with mastitis. The findings were correlated with clinical presentation and course, laboratory findings and clinical outcome.
Four neonates (three girls and one boy) presented with mastitis. They all had prominent breast buds on the affected side with poorly defined margins, slightly more echogenic focally or diffusely compared to normal with hyperemia on color flow Doppler US. The surrounding subcutaneous tissue was thick and echogenic. Two abscesses presented as avascular areas without color flow on Doppler US, subtly increased through-transmission and surrounding hyperemia. One abscess was of increased echogenicity while the other was anechoic.
Neonatal mastitis and breast abscess are unusual diseases that should be appropriately treated with antibiotics and drainage to avoid generalized sepsis, breast hypoplasia, and scarring. US is useful in distinguishing mastitis from breast abscess and guiding treatment options.
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ABSTRACT: The varying presentations of neonatal breast enlargement on imaging have been underreported in the literature. Our case report profiles a 3-week-old female patient who presented with a history of left breast enlargement with redness and tenderness for 2 days, who was clinically diagnosed and managed for neonatal mastitis, which was actually a neonatal breast enlargement with adjacent cellulitis. Awareness that physiologic neonatal breast enlargement can be associated with adjacent cellulitis without mastitis can prevent unnecessary hospitalization and treatment with parenteral antibiotics.
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ABSTRACT: OBJECTIVE: Pediatric breast masses are relatively rare and most are benign. Most are either secondary to normal developmental changes or neoplastic processes with a relatively benign behavior. To fully understand pediatric breast disease, it is important to have a firm comprehension of normal development and of the various tumors that can arise. Physical examination and targeted history (including family history) are key to appropriate patient management. When indicated, ultrasound is the imaging modality of choice. The purpose of this article is to review the benign breast conditions that arise as part of the spectrum of normal breast development, as well as the usually benign but neoplastic process that may develop within an otherwise normal breast. Rare primary carcinomas and metastatic lesions to the pediatric breast will also be addressed. The associated imaging findings will be reviewed, as well as treatment strategies for clinical management of the pediatric patient with signs or symptoms of breast disease. CONCLUSION: The majority of breast abnormalities in the pediatric patient are benign, but malignancies do occur. Careful attention to patient presentation, history, and clinical findings will help guide appropriate imaging and therapeutic decisions.American Journal of Roentgenology 02/2013; 200(2):W204-12. DOI:10.2214/AJR.12.9560 · 2.74 Impact Factor