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==Overview==
==Overview==
==Causes==
'''Nonpuerperal mastitis: Aetiology and Pathogenesis'''


Most clinically significant cases present as inflammation of the ductal and lobular system (galactophoritis) and possibly the immediately surrounding tissue.
Mastitis is mostly  caused by ''[[Staphylococcus aureus|Staphylococcus aureus.]]''<ref name="pmid24145956">{{cite journal| author=Montague EC, Hilinski J, Andresen D, Cooley A| title=Evaluation and treatment of mastitis in infants. | journal=Pediatr Infect Dis J | year= 2013 | volume= 32 | issue= 11 | pages= 1295-6 | pmid=24145956 | doi=10.1097/INF.0b013e3182a06448 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24145956}}</ref>  Other causes include ''[[Staphylococcus epidermidis]]'', ''[[Streptococcus]]'', ''[[Escherichia coli|E. coli]]'', ''[[Mycoplasma]]''  and ''[[Candida (genus)|Candida]].'' 


Secretory stasis is the cause of nonpuerperal mastitis in about 80% of cases (Lanyi 2003). The retained secretions can get infected or cause [[inflammation]] by causing mechanical damage or leaking the [[lactiferous duct]]s.
==Causes==
[[Autoimmune]] reaction to the [[secretion]]s may be also a factor.
===Life-threatening cause===
There is no life-threatening cause of mastitis.
===Most common cause===
The most common cause of mastitis is [[Staphylococcus aureus]]<ref name="pmid24145956">{{cite journal| author=Montague EC, Hilinski J, Andresen D, Cooley A| title=Evaluation and treatment of mastitis in infants. | journal=Pediatr Infect Dis J | year= 2013 | volume= 32 | issue= 11 | pages= 1295-6 | pmid=24145956 | doi=10.1097/INF.0b013e3182a06448 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24145956}}</ref> normally found on the skin.
===Common causes===
Common causes include:
====Pathogenic====
*''[[Staphylococcus epidermidis]]''
* ''[[Streptococcus]]''
* ''[[Escherichia coli|E. coli]]''
* ''[[Mycoplasma]]''.
*[[Fungus|Fungi]], most commonly ''[[Candida (genus)|Candida]]'', that may be found in the oral cavity of the baby.


Several mechanisms are discussed throughout literature that may cause or predispose this (Lanyi 2003, Peters & Schuth 1989, Goepel & Pahnke 1991, Krause et al 1994).
====Non-pathogenic====
*●Tight-fitting brassiere or car seatbelt
*●Oveproduction of [[milk]]
*●Infrequent [[breastfeeding]]
*●Maternal stress
*●Maternal [[malnutrition]]
*●Nipple excoriation or cracking
*●Rapid [[weaning]]


* secretory disease or [[galactorrhea]]
===Less common causes===
* changes in [[permeability]] of lactiferous ducts (retention syndrome)
Less common causes include:
* blockage of lactiferous ducts, for example duct plugging caused by squamous [[metaplasia]] of lactiferous ducts
* [[Autoimmune]] reaction to [[luminal]] [[fluid]]
* trauma, injury
* mechanical irritation caused by [[retention syndrome]] or [[Fibrocystic]] Condition
* [[infection]]
* autoimmune reaction to luminal fluid


About 25% of patients may be hyperprolactinemic and significant coincidence with Fibrocystic Condition and [[thyroid]] anomalies has been documented (Peters & Schuth 1989, Goepel & Pahnke 1991). Up to 50% of patients experience transient [[hyperprolactinemia]] possibly caused by the inflammation or treatment and most had abnormally high [[Prolactin]] reserve (Goepel & Pahnke 1991).


Prolactin, [[IGF-1]] and [[TSH]] are important sytemic factors in galactopoesis, their significance in secretory disease is not documented but it has been asserted that the mechanisms of secretory disease and galactopiesis are closely related (Lanyi 2003).


Permeability the of the alveolar and ductal [[epithelia]] is mostly controlled by tight junction regulation and is closely linked to galactopoiesis and possibly secretory disease. The tight junctions are regulated by a multitude of systemic (prolactin, [[progesterone]], [[glucocorticoid]]s) and local (intramammary pressure, [[TGF-beta]], [[osmotic]] balance) factors (Nguyen & Neville 1998)
===Causes by Organ System===


[[Tobacco smoking]] appears to be an important factor in the aetiology of squamous metaplasia of lactiferous ducts, around 90% of patients with this condition are smokers. Current smokers have the worst [[prognosis]] and highest rate of recurrent [[abscess]]es.
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Chloramine|Chloramines in pool water]], [[Recreational drug use|smoking illicit drugs]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[cyst|Vallecular cyst]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| Oveproduction of [[milk]], Rapid [[weaning]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Staphylococcus aureus]], [[Staphylococcus epidermidis]], [[Streptococcus]], [[Escherichia coli|E. coli]], [[Fungus|Fungi]], most commonly [[Candida (genus)|Candida]], [[Mycoplasma]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|[[Autoimmune]] reaction to [[luminal]] [[fluid]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|[[Nipple]] [[excoriation]] or cracking
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| Infrequent [[breastfeeding]], [[Maternal]] [[stress]], Tight-fitting brassiere or car seatbelt
|-
|}


[[Acromegaly]] may present with symptoms of nonpuerperal mastitis.


[[Diabetes]] and many conditions with suppressed immune system can cause various infections of the breast and mastitis. Such conditions often present with inflammation of peripheral tissue and exotic infections.


Nipple piercings pose a risk due to bacterial infection following the injury and hormonal stimulation by the piercing (Jacobs et al 2003, Modest & Fangman 2002, Demirtas et al 2003).
===Causes in Alphabetical Order===
*[[Autoimmune]] reaction to [[luminal]] [[fluid]]
*''[[Escherichia coli|E. coli]]''
*[[Fungus|Fungi]], most commonly ''[[Candida (genus)|Candida]]''
*●Infrequent [[breastfeeding]]
*●[[Maternal]] [[stress]]
*●[[Maternal]] [[malnutrition]]
*''[[Mycoplasma]]''
*●[[Nipple]] [[excoriation]] or cracking
*●Oveproduction of [[milk]]
*●Rapid [[weaning]]
*[[Staphylococcus aureus]]
*''[[Staphylococcus epidermidis]]''
* ''[[Streptococcus]]''
* ●Tight-fitting brassiere or car seatbelt


==References==
==References==
{{reflist|2}}
{{reflist|2}}


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{{WH}}
{{WH}}
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[[Category:Dermatology]]
[[Category:Emergency mdicine]]
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[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Needs causes]]
[[Category:Gynecology]]
[[Category:Needs overview]]
[[Category:Surgery]]

Latest revision as of 22:38, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

Mastitis is mostly caused by Staphylococcus aureus.[1] Other causes include Staphylococcus epidermidis, Streptococcus, E. coli, Mycoplasma and Candida.

Causes

Life-threatening cause

There is no life-threatening cause of mastitis.

Most common cause

The most common cause of mastitis is Staphylococcus aureus[1] normally found on the skin.

Common causes

Common causes include:

Pathogenic

Non-pathogenic

  • ●Tight-fitting brassiere or car seatbelt
  • ●Oveproduction of milk
  • ●Infrequent breastfeeding
  • ●Maternal stress
  • ●Maternal malnutrition
  • ●Nipple excoriation or cracking
  • ●Rapid weaning

Less common causes

Less common causes include:


Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning Chloramines in pool water, smoking illicit drugs
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat Vallecular cyst
Endocrine Oveproduction of milk, Rapid weaning
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes|-
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus, E. coli, Fungi, most commonly Candida, Mycoplasma
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Autoimmune reaction to luminal fluid
Sexual No underlying causes
Trauma Nipple excoriation or cracking
Urologic No underlying causes
Miscellaneous Infrequent breastfeeding, Maternal stress, Tight-fitting brassiere or car seatbelt


Causes in Alphabetical Order

References

  1. ↑ 1.0 1.1 Montague EC, Hilinski J, Andresen D, Cooley A (2013). "Evaluation and treatment of mastitis in infants". Pediatr Infect Dis J. 32 (11): 1295–6. doi:10.1097/INF.0b013e3182a06448. PMID 24145956.

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