I'm relating this case history second hand - sorry.  I have been requested
to as the mother wants to know of other cases like hers.

She's a doctor nursing a 12-month old in a country town with no LCs.  Her
infant bit her and caused a break in the skin of the areola.  This wound
has continued to get larger and larger.  She apparently treated it with
bactroban once, and antifungals once.  As it got larger a colleague of hers
sutured it.  When the sutures were removed the wound broke down and
reopened.  This happened twice.  There was also a dose of mastitis in there
somewhere.
She has had the wound 'deep sutured' now   (no, I'm sorry I don't really
understand what they have done).  Now she has developed a fistula which is
leaking milk.  I'm not sure what the wound looks like at the
moment.  Another colleague of hers offered to do a wedge resection of it.

My advice, from a distance, never having spoken to the mother, was firstly
to ring an IBCLC doctor to talk about it, but that she will probably need a
full course of the correct antibiotic and probably a course of
fluconazole.  I have mentioned APNO or Kenacomb, but not knowing whether
this wound is wide and gaping again or closed with just a fistula it's a
bit hard to make recommendations.

The mother wants to continue to breastfeed from this side.

Questions:  have you seen anything like this before?  what was the
management and how did it all finally resolve?

Thank you
Denise

*************************************************
Denise Fisher BN, RN, RM, IBCLC
BreastEd Online Lactation Studies
mailto:[log in to unmask]
http://www.BreastEdOnline.com

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