Sonographic features of neonatal mastitis and breast abscess.

BACKGROUND: Neonatal mastitis and neonatal breast abscess are uncommon. Although well described in the pediatric and surgical literature, there is a paucity of reports describing their sonographic features.

OBJECTIVE: To describe and illustrate the sonographic features of neonatal mastitis and neonatal breast abscess.

MATERIALS AND METHODS: We reviewed the medical database of a large children's health-care center from 2000 through 2008 for patients presenting in the first 8 weeks of life with mastitis. The findings were correlated with clinical presentation and course, laboratory findings and clinical outcome.

RESULTS: Four neonates (three girls and one boy) presented with mastitis. They all had prominent breast buds on the affected side with poorly defined margins, slightly more echogenic focally or diffusely compared to normal with hyperemia on color flow Doppler US. The surrounding subcutaneous tissue was thick and echogenic. Two abscesses presented as avascular areas without color flow on Doppler US, subtly increased through-transmission and surrounding hyperemia. One abscess was of increased echogenicity while the other was anechoic.

CONCLUSION: Neonatal mastitis and breast abscess are unusual diseases that should be appropriately treated with antibiotics and drainage to avoid generalized sepsis, breast hypoplasia, and scarring. US is useful in distinguishing mastitis from breast abscess and guiding treatment options.