Clinicodiagnostic management and bacteriological etiology of non-puerperal mastitis in the population of Southern China

Yandan Yao, B. Dong, Wei Wu, Quan Li, Yang Chen, Baiji Chen, Y. Jiang, Mingxia Zhang, Shi Liang, Yonghua Li, Songyin Huang
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Abstract

Abstract This study aimed to describe the clinicopathologic characteristics of non-puerperal mastitis and to investigate spectrum of organisms causing it in the population of Southern China. We retrospectively registered 364 female patients with histological confirmation of inflammatory disease of the breast in the non-lactational phase, who were admitted to our institution over an 11-year period (2005–2016). Clinical, laboratory, and radiographic imaging features, as well as their bacteriological etiology, were analyzed in detail. In this study, 117 patients were diagnosed with periductal mastitis (PDM)/mammary duct ectasia (MDE) and 247 patients were diagnosed with idiopathic granulomatous mastitis (IGM). There were significant differences in terms of mean age of onset, menstruation period, and menstruation history. Nipple discharge, inverted nipple, and the ratio of abscess and fistula were more spontaneous in women with PDM/MDE compared to IGM. The inflammatory biomarkers including leukocyte count, neutrophil percentage, and high-sensitivity C-reactive protein in PDM/MDE group were significantly higher than IGM group. For bacteriological etiology, the most commonly isolated organism was Corynebacterium kroppenstedtii (C kroppenstedtii) in the IGM group and Staphylococcus in the PDM/MDE group. The study shows that the combination of demographic characteristics and clinicopathological characteristics was helpful in differential diagnosis of PDM/MDE and IGM. IGM can be associated with C kroppenstedtii, providing a possible effective therapeutic and preventive method by targeting this kind of bacilli.
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华南地区非产褥期乳腺炎的临床诊断、管理及细菌学病因分析
摘要本研究旨在描述中国南方非产褥期乳腺炎的临床病理特征,并调查引起乳腺炎的微生物谱。我们回顾性登记了364例组织学证实为乳腺炎症性疾病的非哺乳期女性患者,这些患者在11年期间(2005-2016年)入院。临床,实验室和影像学特征,以及他们的细菌学病因进行了详细分析。在本研究中,117例患者被诊断为导管周炎(PDM)/乳腺导管扩张(MDE), 247例患者被诊断为特发性肉芽肿性乳腺炎(IGM)。在平均发病年龄、月经周期和月经史方面存在显著差异。与IGM相比,PDM/MDE女性的乳头溢液、乳头内陷、脓肿和瘘管的比例更自然。PDM/MDE组炎症标志物白细胞计数、中性粒细胞百分比、高敏c反应蛋白均显著高于IGM组。在细菌学病原学方面,IGM组中最常见的分离菌为克罗氏棒状杆菌(C kroppenstedtii), PDM/MDE组中最常见的分离菌为葡萄球菌。研究表明,结合人口学特征和临床病理特征有助于PDM/MDE和IGM的鉴别诊断。IGM可能与克氏杆菌相关,为针对这种杆菌提供了一种可能的有效治疗和预防方法。
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