05.04.2020 Breast Abscess

My patient I have been treating conservatively for the breast abscess was back today.  She told me that she had milk coming out of the puncture hole every time she breast feeds.  I examined her again with Ultrasound and found a rather small remainder of presumable abscess close to the pectoralis muscle, deep in the breast tissue.  Palpation revealed that not milk but pus mixed with some serous fluid and a little blood exited the hole.  Upon applying more pressure, more drainage took place until finally only a bit of serous fluid came out.  Ultrasound showed a very small remaining cavity (4,3 mm) which given the possibility to drain externally should hopefully close on its own once completely empty.  The patient was very happy, fever free and had taken her antibiotics a full week after the last puncture. I scheduled her for a follow up in a week.  All in all I’m very content to have achieved a good result in 3 punctures and spared her an operation 😊

Before: 3,7 cm

After 3 Punctures: 0,43 cm or 4,3 mm
This picture is the result of follow-up one week later.

Sandra's punction fistula has healed and the scan showed only a tiny fluid filled cavity.  She has no pain, no fever and the palpation of the breast reveals there is no more nodule.  I am super happy.  Mom and baby are finally discharged from my care.