I also had a recent patient with group A beta hemolytic strep mastitis
(=strep pyogenes). Her toddler had strep throat, and she developed
mastitis from his strep throat. It took her many weeks to improve. The
problem is that the infection is in the ducts, and it is hard to get
good drug levels in the ducts. Sometimes strep infections are coinfected
with staph too (I saw that recently too). I would broaden her antibiotic
to a cephalosporin, make sure the strep is tested for sensitivity to
clindamycin and erythromycin in case a cephalosporin does not work.
These ductal breast infections can take at least 6 weeks to get better,
as I described in a recent email.
Anne Eglash MD
Clinical Associate Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)

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