Mastitis. Puesta al día

Abstract

RESUMENLa mastitis es una de las principales causas de abandono evitable de la lactancia materna, con el aumento de la morbimortalidad infantil que ello supone, pero no hay uniformidad en los criterios diagnósticos ni terapéuticos. El diagnóstico de la mastitis aguda es fundamentalmente clínico, y, solo en determinados casos, está indicado el cultivo de leche. El drenaje del pecho es fundamental en el tratamiento, por lo que debe mantenerse la lactancia. Si persisten los síntomas o si existe mucha repercusión clínica, se iniciará la antibioterapia. No hay pruebas suficientes de la etiopatogenia de otros tipos de mastitis (subclínica y subaguda) ni de que sean responsables del dolor mamario o el escaso aumento ponderal del lactante. Tampoco sobre la efectividad de los probióticos en el tratamiento y prevención de la mastitis. El objetivo es realizar una evaluación de la información disponible sobre la clínica, diagnóstico y tratamiento de las mastitis para ofrecer una visión actualizada del tema. Palabras clave: mastitis aguda, mastitis subaguda, probióticos, mastodinia. ABSTRACTMastitis is one of the main causes of avoidable cessation of breastfeeding which increases morbidity in childhood, however, there is no uniformity in diagnostic and therapeutic criteria. The diagnosis of acute mastitis is mainly clinical. Only in certain cases, a milk culture is indicated. Regarding treatment of mastitis, it is fundamental to empty the breast, so breastfeeding should continue. It is recommended to start antibiotic therapy if symptoms persist or if there is considerable clinical impact. There is insufficient evidence of the importance of other types of mastitis (subclinical and subacute). There is also a lack of evidence that these types of mastitis are responsible for breast pain or for low infant weight gain. Furthermore, there is not enough evidence regarding the effectiveness of probiotics in the treatment and prevention of mastitis.The aim of this article is to review the available information related to clinical signs, diagnosis and management of acute mastitis in order to give an updated overview.

Candida guilliermondii as an agent of postpartum subacute mastitis in Rio de Janeiro, Brazil: Case report

“…The symptoms of mastitis are mainly swelling, pain and redness in the breasts, fever, tiredness, and the presence of discharge. Complications of mastitis include the development of abscesses, interruption of breastfeeding, and an increased risk of neonatal infections (Espínola-Docioa et al, 2016;Angelopoulou et al, 2018;Boakes et al, 2018;Moubareck, 2021). The prevalence of mastitis in lactating women ranges from 2.5% to 40%, according to the geographical region (Wilson et al, 2020).…”