Pneumococcal puerperal mastitis in a lactating mother

Abstract

Introduction A case of pneumococcal mastitis in a breast-feeding mother 6 months postpartum is described. Mastitis is usually caused by Staphylococcus aureus . A review of the literature from 1950 to March 2018 revealed only four other cases in which the causative organism was Streptococcus pneumoniae . Case presentation The nursing mother presented with high fever and the four cardinal signs of inflammation of the left breast: calor, dolor, rubor, tumour. In milk culture Streptococcus pneumoniae was isolated in numbers exceeding 10 5 c.f.u. ml −1 . The strain was of polysaccharide serotype 11 not included in Prevnar-13. Susceptibility testing showed full sensitivity to β -lactam antibiotics as well as to macrolides, lincosamides, vancomycin and tetracycline. Conclusion Streptococcus pneumoniae should be considered as a possible causative agent of puerperal mastitis.

Pneumococcal lactational mastitis in a healthy woman

“…Two cases7 8 showed that an infected child could cause S. pneumoniae mastitis in the mother. Four other cases9–12 suggested an association with S. pneumoniae mastitis, even if the child was asymptomatic. The exact mechanism underlying this infection remains unclear; however, both host and pathogen factors are thought to play a key role 16.…”

“…Pneumococcal non-lactational mastitis has rarely been reported in patients with underlying diseases, such as systemic lupus erythematosus; however, reports of pneumococcal lactational mastitis are scarce, with only six cases reported in the English literature between 1995 and 2021 (table 1). 7–12…”

“…Except for two cases (29%)7 8 who had minor upper respiratory tract symptoms, all patients were asymptomatic. Paediatric pneumococcal vaccines were administered with PCV-7 in one case10 and PCV-13 in two cases 12. The serotypes of S. pneumoniae detected in five cases7 10–12 were 6 B, 19A, 19F, 11 and 15C.…”

“…Paediatric pneumococcal vaccines were administered with PCV-7 in one case10 and PCV-13 in two cases 12. The serotypes of S. pneumoniae detected in five cases7 10–12 were 6 B, 19A, 19F, 11 and 15C. In three cases,7 10 11 the infection could have been prevented by PCV-13 vaccination; two others12 were not included in the PCV-13.…”

Skin and soft tissue infection caused by Streptococcus pneumoniae: report of 15 cases

“…Debemos destacar dos casos de mastitis lactacional y uno de fascitis necrotizante. La mastitis lactacional neumocócica es excepcional, habiéndose descrito 5 casos desde 1995 [13][14][15]. En todos ellos, S. pneumoniae se aisló en los cultivos de leche materna, y su presencia se atribuyó a la transmisión desde el niño en el momento del amamantamiento.…”