Hello all,

One of my coworkers who is not lactating asked me to look at her breast
because she was having intense pain in her left breast of sudden onset.  A
few months ago she had similar pain in the right breast with redness,
warmth, low grade fever, and redness.  She was diagnosed with mastitis and
had 2 courses of antibiotics and it resolved.  She was not lactating at that
time either.  I did a thorough breast exam and found nothing unusual except
intense pain about 3-4:00 radiating out to the midaxillary line with
palpation and a wedge of contracted areola at 12-1:00 extending about an
inch up into the breast but no nipple involvement.  To me it appeared to be
of nerve origin, not breast origin.  She had a history of having chickenpox
and I suspected Herpes Zoster (shingles) but had never heard of shingles
without lesions.  Sure enough, she got an appointment with her OB the next
day and he confirmed shingles and gave her and antiviral prescription.  An
internet search describes this as Zoster sine herpete.  I gave her some
Hydrogel dressings and they relieved some of the exquisite sensitivity to
touch by placing a barrier between her skin and clothes.  Not sure how
common it is to have shingles bilaterally at different times but something
to consider with moms who have unusual breast pain.

Linda Anderegg, RNC, IBCLC, RLC in Chicago    


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