A case of lactational mastitis and breast abscess

A case of lactational mastitis & breast abscess and its homoeopathic cure

Dr J Swathi

ABSTRACT:
Post partum mastitis occurs sporadically in nursing mothers, usually with symptom onset after discharge from the hospital, or it may occur in epidemic form in the hospital. Mastitis frequently begins within three months after delivery and may start with an engorged breast and a sore or fissured nipple. Mastitis can range from superficial cellulitis to abscess. A female patient aged 27 years was presented with mastitis and abscess of right breast with symptoms of fever, swelling, hardness and tenderness. Homoeopathic medicines Belladonna, Bryonia were selected and administered basing on the totality of symptoms and individualization, abscess was healed completely and recurrence was prevented.

KEYWORDS: MASTITIS, BREAST ABSCESS, HOMOEOPATHY, BELLADONNA, BRYONIA

INTRODUCTION:
Acute mastitis is commonly seen in child bearing age particularly during lactation. Bacteria enter the breast either through the blood stream or through the lactiferous ducts; the latter is due to trauma during lactation. Pain is the first symptom which is dull in the beginning and gradually becomes a continuous throbbing pain. This condition leads to suppuration and formation of intramammary abscess1. Staphylococcus aureus is usually the causative agent, inflammation is generally unilateral, and women nursing for the first time are more often affected.

Cellulitis is usually obvious in the affected area of breast with redness, tenderness and local warmth. Fever and chills are common complaints as well.

Allopathic treatment consists of antibiotics effective against penicillin- resistant staphylococci and regular emptying of the breast by nursing or by using a mechanical suction device. Although nursing of the infected breast is safe for the infant, local inflammation of the nipple may complicate latching.

Failure to respond to usual antibiotics within 3 days may represent an organizing abscess or infection with resistant staphylococcus aureus. In these cases, aspiration or surgical evacuation is usually required2.

A CASE OF MASTITIS AND BREAST ABSCESS:

A lactating female aged 27 years reported with complaints of fever, swelling, pain, and hardness in right breast since one week. Pain is of stitching type, with soreness around areola. Pain is radiating to nipple. Pain aggravates when milk is not emptied, and on movement. Pain is ameliorated by holding the breast up.

History of presenting complaints:

Patient has delivered a male child by lower segment cesarean section. She developed temperature with pain and redness in right breast one week after her delivery. She was diagnosed with clogged duct and mastitis. She was prescribed antibiotics, but she gradually developed abscess with stony hardness of right breast and tenderness is reported. She underwent surgery, had incision and drainage of the pus and was advised for regular expressing of milk and dressing at the site of surgery. Within fifteen days she again developed fever with chills, swelling, heaviness with pain and hardness of the right breast. Milk secretion from right breast has reduced and she could not express milk from the affected breast. Patient did not want to go for surgery again; hence she opted for homoeopathic treatment.

On examination, the swelling is present in right upper and outer quadrant of breast, warm on touch; hardness around the swelling is present with tenderness. There are no palpable axillary or clavicular lymph nodes.

Along with chief complaints she has anxiety regarding her condition, she got frightened that she will face many health consequences because of cesarean section. Her mother said she is the only one  in entire family who has  undergone cesarean section and she scolded her that she  did it wantedly to avoid pains, patient got upset and became anxious regarding her health, thirst increased than before, sleep is disturbed due to pain.

PAST HISTORY:  Past history was uneventful.

Physical generals: Patient is towards hot thermal (wants fanning always, prefer cold climate); perspiration is on scalp and forehead, thirst for large quantities, desires spicy food, stool is soft, regular. Appetite is satisfactory, sleep is refreshing.

ANALYSIS OF THE CASE:

On considering the acute totality, these symptoms were repertorised using synthesis repertory

  1. Anxiety regarding health
  2. Thirst increased
  3. Fever accompanied by suppuration
  4. Inflammation mammae right
  5. Hardness of mammae
  6. Milk obstructed (failing to release the milk)

Selection of Remedy: Belladonna

Potency and dose: 200 in plus potency (first prescription)

Advised to repeat once in every 4 hours, for 2 days

DISCUSSION: A case of gestational mastitis and abscess has been cured by individualized homoeopathic medicine. Belladonna was given on basing acute totality with relief of the presenting complaints. During the course of treatment considering the then totality Bryonia was prescribed. The case was documented photo-graphically at onset, during and after the course of treatment. The treatment outcome has proved the efficacy of homeopathic treatment in breast abscess and mastitis. The long term follow up has suggested that there is no reoccurrence even after the cessation of treatment.

CONCLUSION:  Homeopathic system has ample scope in treating the mastitis, abscess and ulcers with great outcome and the reoccurrence is stopped in this case. Further research in these cases can raise the interest and approach to the homoeopathic medicine as choice of treatment for patients.

REFERENCES:

  1. S., “A manual on Clinical Surgery”, 12th edition, November 2016, copyright © DR. S. DAS., published by Dr. S. Das, 13 Old Mayors Court, Kolkata – 700005, India.
  2. Maxine A. Papadakis, Stephen J. Mcphee, Michael W. Rabow (associate author), “Current Medical Diagnosis and Treatment 2014”, 53rd edition, Copyright © 2014 by McGraw-Hill Education.

J SWATHI, MD(Hom)
Assistant professor in dept of physiology,
MNR homoeopathy medical college, Fassalwadi, Sangareddy.

Download full paper with images and followups