A 32-year-old heavy smoker who has never been pregnant presents with recurrent episodes of a tender subareolar mass that discharges pus through a small opening at the edge of the areola. The most likely causative organisms are:
- A Mixed aerobic and anaerobic organisms ✓
- B Staphylococcus aureus alone
- C Mycobacterium tuberculosis
- D Candida albicans
Correct answer: A. Mixed aerobic and anaerobic organisms
Explanation
This is periductal mastitis with a mammary duct fistula, a disease of young smokers unrelated to lactation. Squamous metaplasia of the lactiferous ducts leads to duct obstruction, inflammation and secondary infection with mixed aerobes and anaerobes. Recurrent attacks can culminate in a persistent fistula opening at the areolar margin, which requires fistulectomy with excision of the involved ducts. Smoking cessation is essential because recurrence otherwise is frequent.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.