Red Breasted

Author: Emily Stokes, Jennifer Cochrane / Editor: Nick Tilbury / Codes: SLO1, SuC5 / Published: 22/08/2022

A 32-year-old woman attends the Emergency Department (ED) with a 16-hour history of rapidly progressing right-sided breast erythema and swelling. She is 4-weeks post-partum, currently breast feeding and presents with her baby.

She has no significant past medical history and had a negative blood-borne-virus (BBV) screening test done antenatally. She has a maternal family history of breast cancer. Her only current medication is ferrous sulphate for pregnancy-related anaemia.

On examination, she has a tender, erythematous right breast with a wedge-shaped mass supero-laterally to the nipple. She has no nipple inversion but has evidence of nipple fissures bilaterally. Her C-section scar appears healthy and the rest of her examination is normal.  She is haemodynamically stable with a heart rate of 88 and a temperature of 38.2 in the department. Bloods demonstrate an elevated CRP of 125 and WCC of 13.3. Point-of-care COVID test is negative.

You ask her to obtain a sample of breast milk for culture.