Bloody nipple discharge in infants

East Sussex Healthcare NHS Trust, Eastbourne, England, United Kingdom
The Breast (Impact Factor: 2.38). 05/2006; 15(2):253-4. DOI: 10.1016/j.breast.2005.05.004
Source: PubMed


Though milky nipple discharge is frequently seen in neonates, blood stained discharge from the nipple is an exceptionally rare phenomenon. We noted a case of a three-month-old baby girl who presented with bilateral blood stained nipple discharge without signs of inflammation; engorgement or hypertrophy and which subsided without any intervention. This case is reported along with literature review about managing this rare condition.

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    • "Kelly et al14) mentioned a diagnostic approach to the evaluation of bloody nipple discharges in infants. In an infant apparently experiencing bloody nipple discharge, the initial workup should include a Gram-stain; cell count and culture of the discharge; serum levels of prolactin, estradiol, and thyrotropin; and an ultrasound of the affected breast. "
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    ABSTRACT: Although milky nipple discharge appears frequently in infants, bloody nipple discharge is a very rare finding. We experienced a 4-month-old, breast-fed infant who showed bilateral bloody nipple discharge with no signs of infection, engorgement, or hypertrophy. The infant's hormonal examination and coagulation tests were normal, and an ultrasound examination revealed mammary duct ectasia. The symptoms resolved spontaneously within 6 weeks without any specific treatment, except that we advised the mother to refrain from taking herbal medicine. Since no such case has been previously reported in Korea, we present this case with a brief review of the literature.
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    ABSTRACT: Bloody nipple discharge occurs rarely in infancy and may be secondary to mammary ductal ectasia. Discharge commonly resolves spontaneously, and ultrasonography is a useful diagnostic technique to detect the cause of discharge. We report a 28-month-old boy who presented with unilateral bloody nipple discharge for one month without signs of infection or mass. Ultrasound examination showed a dilated duct in the retroareolar region. No atypical cells were present on cytologic evaluation of the discharge. Further diagnostic studies were avoided and the discharge ceased completely one month later. We conclude that bloody nipple discharge is usually a benign and self-limited process in infancy and that it is advisable to avoid unnecessary invasive investigations initially. Invasive diagnostic studies or surgery should be reserved for cases with a palpable mass, persistent discharge or equivocal ultrasonographic findings.
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