Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2023; 11(8): 1847-1856
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1847
Lactation breast abscess treated with Gualou Xiaoyong decoction and painless lactation manipulation: A case report and review of literature
Li-Hua Jin, Hui-Ling Zheng, Yun-Xia Lin, Yi Yang, Jia-Li Liu, Rui-Lan Li, Hui-Jun Ye
Li-Hua Jin, Hui-Ling Zheng, Yun-Xia Lin, Yi Yang, Jia-Li Liu, Rui-Lan Li, Hui-Jun Ye, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
Author contributions: Jin LH, Ye HJ and Zheng HL conducted the studies, participated in collecting data and drafted the manuscript; Lin YX, Yang Y, Liu JL and Li RL drafted the manuscript; All authors read and approved the final manuscript.
Supported by Zhejiang Traditional Chinese Medicine Science and Technology Plan, No. 2023ZL449.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Jun Ye, BM BCh, Chief Doctor, Professor, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, No. 318 Chaowang Road, Gongshu District, Hangzhou 310005, Zhejiang Province, China. 1320779970@qq.com
Received: December 8, 2022
Peer-review started: December 8, 2022
First decision: December 26, 2022
Revised: January 9, 2023
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: March 16, 2023
Processing time: 88 Days and 22 Hours
Abstract
BACKGROUND

Breast abscess during lactation is a severe complication of acute mastitis, which can lead to discomfort, high fever, breast fistula, sepsis, septic shock, breast damage, disease persistence and frequent hospitalization. Breast abscesses may also lead the mother to discontinue breastfeeding, thereby harming the infant’s health. The predominant pathogenic bacteria are Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus. The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0% and 11.0%. In cases of breast abscess, the rate of cessation of lactation is 41.0%. In instances of breast fistula, the rate of cessation of lactation is very high (66.7%). Furthermore, 50.0% of women with breast abscesses must be hospitalized and treated with intravenous antibiotics. Treatment includes antibiotics, abscess puncture and surgical incision and drainage. The patients suffer from stress, pain and easily induced breast scarring; the disease’s progression is prolonged and recurrent, interfering with infant feeding. Consequently, it is crucial to discover an adequate cure.

CASE SUMMARY

A 28-year-old woman with a breast abscess was treated with Gualou Xiaoyong decoction and painless breast opening manipulation 24 d after cesarean delivery. On the 2nd d of treatment, the patient’s breast mass was significantly reduced, the pain was significantly reduced, and the general asthenia was improved. All conscious symptoms disappeared after 3 d, breast abscesses faded after 12 d of treatment, inflammation images disappeared after 27 d, and normal lactation images were restored.

CONCLUSION

In treating breast abscesses during breastfeeding, the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact. This disease’s treatment offers the advantages of a short course of treatment, no need to discontinue breastfeeding and the ability to rapidly mitigate symptoms, which can be used as a reference in clinical practice.

Keywords: Lactation breast abscess; Gualou Xiaoyong decoction; Painless lactation manipulation; Literature review; Case report

Core Tip: Breast abscess during lactation is a serious complication of acute mastitis, which can cause breast pain, fistula, sepsis, septic shock, breast destruction, disease persistence and discontinuation of lactation. Current treatment includes antibiotics, abscess puncture and surgical incision and drainage. Patients suffer from stress and discomfort, which readily induces breast scarring. Moreover, the disease’s progression is prolonged and recurrent, interfering with newborn feeding. This article described a case of breast abscess that was cured with Gualou Xiaoyong decoction combined with painless breast opening therapy. The advantages are a short treatment course, no trauma, inexpensive, lactation continuation and rapid symptom improvement.