Most of the women I have seen with abscess formation have presented in my
office prior to febrile symptoms.  Their most striking sx is a mass which
has rapidly grown.  There is typically a reddened area (erythema) above the
lump, and it is tender to very painful.  The surgeon I work with told me
once that prob. 25% of patients presenting in his office with abscess are
afebrile.  So fever is not always a symptom we can rely on.  In fact, some
of the new info on mastitis in general makes the suggestion that deep pain
is more commonly a dependable sx of mastitis than is fever.  Lisa Amir's
wonderful new article in JHL reviewing the histories of 107 women presenting
to an emergency room with mastitis states:  "Not all the women were febrile:
almost 40% were afebrile and only 27% had a temp. of 38.5 degrees C or
higher...Therefore, the evidence for the presence of a fever of 38.5 degrees
C in women with mastitis needs to be reexamined."

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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