Hi Barbara

I just found this definition:


phleg·mon

  (fleg'm n),
Spreading inflammation resulting from 
streptococcal infection that may extend beneath 
the skin and muscles and may produce pus or gangrene.
[G. phlegmon , inflamed swelling, fr. phlegma, flame]

Personally, I've never seen an abscess that _was_ 
close to the surface although I''ve seen many 
pics that show abscesses so close to the surface 
that they can drain spontaneously.  What you 
describe sounds worrying.....in fact the defining 
characteristic of doctors dealing with what 
eventually turns out to be abscess is..... 
delay!  It seems to take weeks before a decision 
is made to diagnose it properly (ultra-sound) and 
or finally treat it (incision and drainage).

Best to your client - maybe she can give you 
daily updates while she's away, so that you can 
send her to her nearest ER if this potential 
abscess flares up again. The other option might 
be for her to receive another course of 
antibiotics to cover the time that she's 
away.  Is Bactrim effective against a strep 
infection? If there has been no change in the 
week she's away, then she might need to get 
proactive with her doctor about treating 
it.  I've found that there's _not_ always fever, 
and that as the abscess progresses it may even 
become _less_ painful..... But it just doesn't go away!

Keep us posted!  This sounds like an interesting 
but nail-biting case that we could learn from!

Pamela Morrison IBCLC (just re-certified!!!) in Rustington, England :-)
---------------------------------------------
Dear Friends,
I am being challenged today! I just saw a mother at 8 weeks PP who
developed suddenly, no plugs first, just swollen, red, streaky on left
breast at 9 o'clock position, at 6 weeks. She was put on Keflex for 10
days by her midwife which made her feel much better after 24 hours.
At seven weeks we developed a wedge of hardness above her left nipple.
Very tender, not red. Fever and flu like symptoms again. She was sent to
triage where they did a blood draw. She had an elevated white count.
They did an ultrasound and found a mass three inches above her nipple.
They thought it was cancer so they sent her to the cancer clinic where
they did another ultrasound and a biopsy. It was not cancer. She was
told it was a mass, some said an abscess, filled with phyegmon. She was
put on Bractrim for 10 days again. They did another ultrasound that
showed the mass was reducing in size at day 5. It was 1 cm by 3 cm but
we don't know the current measurement, they just said it was reducing in
size.
Now, the mother is leaving for a week long trip to Texas. Her
antibiotics run out on Monday, she leaves on Tuesday.
We are worried that they didn't drain this or that it will flare up
again after the antibiotics run out. I have never had an abscess that
wasn't at the surface. I had never heard of "phyegmon".
The breast specialist said they see this all the time and it will be fine.
Thank you!

-- 

Barbara Robertson, MA, IBCLC, RLC
The Breastfeeding Center of Ann Arbor
bfcaa.com



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