>Has anyone else had a similar experience with an abscess in an afebrile
>patient who experiences no pain?  I think the encapsulation theory is
>correct, but the cause is not clear.  Any ideas?
>
Hi Esther,
I have seen quite a few women with abscesses and mostly they are afebrile
and feeling well. The pain in the affected area of the breast does vary.
I'm sure you're right about the infection getting walled off early on.
The commonest bacteria found in breast abscesses is Staph aureus, and this
bug has a tendency to form abscesses. I don't think we need to imagine
unusual organisms like TB - but I think  it is always reassuring to send off
the pus for culture to confirm the organism. Sometimes an abscess occurs
even when the mother and health professionals did all the right things (freq
drainage, correct antibiotic -eg dicloxacillin - not amoxycillin or plain
old penicillin) - it is the fault of the organism not anyone else.
Lisa Amir
MBBS, IBCLC in Melbourne, Australia - snow is starting to fall in the
mountains, must check the ski-gear!

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