Purulent discharge from the nipples - yellow-green discharge with an unpleasant odor from one or two mammary glands. The symptom is accompanied by sharp pains in the chest, local redness and swelling of the skin, fever. The main cause of purulent discharge is various forms of mastitis and their complications, suppuration from the nipples is also observed with areola boils, chest injuries. To identify the cause of the condition, ultrasound, mammography, and bacteriological culture of the discharge are performed. To relieve symptoms, analgesics, anti-inflammatory drugs are used.
Purulent discharge is most often caused by inflammation of the mammary gland. In 90% of cases, this is due to breastfeeding (lactational mastitis). Droplets of purulent discharge from the nipples appear after pressure on the chest, their release can be facilitated by squeezing the breast with a tight bra. Mastitis is characterized by damage to only one breast, which is manifested by a sharp asymmetry due to tissue edema. Women note a combination of discharge with reddening of the skin, a sharp soreness of the affected area, and fever.
Non-lactational mastitis proceeds with a similar clinical picture. Some patients associate the presence of purulent discharge with bruising of the chest, skin injuries (cuts, abrasions). The outflow of pus from one nipple begins with pressure on the areola area. The symptom is accompanied by unbearable pain in the breast, the skin in this area becomes red and very hot to the touch. Suppuration from the nipple is a sign of severe bacterial damage to the glandular tissue, so the patient should seek medical help as soon as possible.
Without treatment, the inflammatory disease often turns into a breast abscess - a massive formation filled with pus. This condition is combined with the periodic spontaneous appearance of purulent discharge from the nipples, in the discharge, blood clots and impurities of necrotic tissues can be found. The mammary gland is highly edematous, women complain of sharp pains at rest, which are aggravated by movement. Suppuration with the release of scanty thick yellow-green contents also occurs in the formation of fistulas due to chronic inflammation.
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The reason for the release of pus from the nipples can be inflammatory skin lesions - boils and carbuncles, if they are localized in the areola. Pathological discharge appears when an abscess is opened into the lumen of the lactiferous passages. Patients note the sudden appearance of thick greenish pus with a sharp unpleasant odor, the amount of purulent discharge varies from a couple of drops to several milliliters. On the skin of the chest, closer to the nipple, a painful hyperemic elevation is found. After the discharge of pus, the condition improves, the pain subsides.
Examination of patients with suppuration from the nipples is carried out by a mammologist or surgeon. During the diagnosis, the doctor collects a detailed history, conducts an external examination and palpation of the mammary glands to make a preliminary diagnosis. To establish the causes of purulent discharge, a complex of laboratory and instrumental methods is prescribed, the most informative of which are:
If a volumetric formation is detected, a puncture under ultrasound control is necessary, which allows differentiating abscesses with suppuration of the tumor formation. Cytological examination of purulent discharge from the nipple is carried out in doubtful cases to exclude oncological pathology.
Examination of a smear from the nipple of the breast
The appearance of purulent discharge from the nipples indicates a massive inflammatory process in the mammary glands, so self-medication can lead to severe complications and generalization of the infection. You can not specifically compress the chest and areola to squeeze out pus, it is undesirable to wear tight bras, as they increase discomfort. With unbearable pain in the affected chest, various analgesics are used. Self-administration of antibiotics without a doctor's prescription is fraught with the transition of the disease into a chronic form, which is less treatable.
Medical tactics depend on the degree of tissue damage, the presence of encapsulated purulent foci, the general condition of the woman. Drug treatment as an independent method is used only in the early stages of the disease. During the treatment period, the mammary gland is given an elevated position to reduce pain. Nursing mothers should regularly use a breast pump to prevent lactostasis. With suppuration from the nipples appoint:
The accumulation of pus in the mammary gland is an indication for a minor surgical intervention - opening of purulent foci and installation of drains. In the presence of a single abscess of small size, it is usually limited to a puncture of the formation under ultrasound control, followed by aspiration of the contents. When a large abscess is formed, purulent fusion of glandular tissue requires opening and drainage of mastitis, extended operations, including excision of the affected areas (sectoral resection, quadrantectomy).