A 32-year-old woman presents with a sudden onset of painful, erythematous swelling in the upper outer quadrant of the right breast. She is currently breastfeeding her 4-month-old infant. On examination, there is a tender, warm, indurated area with no palpable fluctuant mass. What is the most appropriate next step in management?

• A Immediate incision and drainage
• B Oral antibiotics against Staphylococcus aureus and continued breastfeeding ✓
• C Ultrasound-guided aspiration
• D Empirical antifungal therapy

Explanation

Lactational mastitis is most commonly caused by Staphylococcus aureus and is initially managed with antibiotics (dicloxacillin or cephalexin) and continued milk expression to prevent abscess formation. Incision and drainage or aspiration is reserved for cases that progress to a breast abscess despite antibiotic therapy.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.