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Subject:
From:
Amir family <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 3 Jul 2001 19:53:20 +1000
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<Also, am interested in
hearing from someone who has seen Herpes on the breast.  Any tricks on how
to recognize it or identify it? >
I have seen one woman who was feeding a child of about 12 months. She
developed several very painful sores around each areola. She had seen one
doctor who diagnosed a bacterial infection and gave her antibiotics. Because
of the severe pain she also went into the emergency department at one of our
maternity hospitals, where the doctor diagnosed thrush and gave her gentian
violet. I saw her a couple of days later and she had 4 to 6 crusty lesions
on each breast. Otherwise the skin of the nipples, areolae and breasts were
normal.

While taking the history we make a mental list of possible differential
diagnoses. Most of the time we are likely to make the diagnosis after
listening to the mother's story and asking the appropriate questions. On
examination, we weigh up the evidence for each possible diagnosis. I was
thinking of herpes even before seeing her breasts - b/c of the description
of "sores", the extreme pain and no response to other treatment.

She had already cut back from 3 feeds a day to once a day (or something like
that - this is from memory). The child had no signs of herpes. The mother
said that her partner had recently had a "cold sore" (oral herpes).

She gave me permission to take a photograph, but later I found the camera
had no film


Lisa Amir
MBBS, MMed, IBCLC - who gave up trying to take photos after several similar
episodes a few years ago, but now has access to a digital camera and should
start clicking again!

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