Acute Mastitis

Common causes

  • Duct Ectasia
    • Usually causes a mixed/anaerobic infection
  • Lactation
    • Usually causes a S. aureus/Strep pyogenes infection
  • NB more common in patients with diabetes, HIV, chronic illnesses etc

Clinical Presentation

  • Pain, redness warmth
  • Tenderness and swelling
  • May have a purulent (+/- bloody) nipple discharge
  • May also have a fever/systemic illness


  • If there is discharge- swab for C&S
  • Antibiotic treatment-
    • If lactation is likely to be the cause: a penicillin (Flucloxacillin) is useful
    • If duct ectasia (esp if smoker) more likely: it may be useful to add metronidazole
  • If there is an underlying problem with the duct or another predisposing condition, treat this also.

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