Last time I saw a woman with mastitis that would not respond to appropriate antibiotic treatment, she had an abcess. She had no fever, ever, but kept treating and treating... The breast becamen very red and scaly. I refered her to two (2) (TWO) physicians (personal phone calls, md to md, you get the picture) without any result. Finally, our breastfeeding friendly but very busy breast surgeon saw her, drained the abcess, and told me these two interesting facts: - abcesses are not always accompanied with fever, - 10 to 15 % of mastitis will result with abcess, in spite of appropriate antibiotic treatment. The longer the interval between the symptoms and the beginning of the treatment, the higher the risk of no response. Hope this helps. Louise Denhez, M.D., M.P.H Chargee d'enseignement clinique Departement de medecine sociale et preventive