title: Periareolar nonpuerperal breast infection: treatment of 38 cases.
abstract: Periareolar nonpuerperal breast infection is a troublesome entity whose treatment is still a matter of debate. Thirty-eight female patients--9 with acute infection and 29 with chronic infection--were prospectively studied over a 3-year period. Sixty isolates were harvested from 50 pus specimens obtained by fine-needle aspiration, with a predominance of staphylococci (23 isolates) and peptostreptococci (18 isolates). On the basis of these findings, an antimicrobial regimen consisting most often of amoxicillin plus clavulanic acid was administered for 6-8 weeks. Simultaneous surgery was required in 13 cases (34.2%). Despite a good response during therapy, 7 (21.9%) of 32 patients relapsed during a follow-up period of < or = 3 years; all 7 patients had presented with chronic infection. We conclude that prolonged therapy with agents active against both staphylococci and anaerobes is essential in periareolar breast infection; in cases with an established fistula, radical surgery (i.e., fistulotomy or fistulectomy) appears inevitable.
authors.affiliation: First Department of Propedeutic Medicine, Athens University School of Medicine, Laiko General Hospital, Greece.
authors.forename: H
authors.initials: H
authors.lastname: Giamarellou
authors.forename: M
authors.initials: M
authors.lastname: Soulis
authors.forename: A
authors.initials: A
authors.lastname: Antoniadou
authors.forename: J
authors.initials: J
authors.lastname: Gogas
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents; D001424:Bacterial Infections / Q000382:microbiology / Q000628:therapy*; D001941:Breast Diseases / Q000382:microbiology / Q000628:therapy; D002908:Chronic Disease; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009558:Nipples; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents