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Lactational Breast Abscess — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlLactational Breast AbscessSCE Infectious Diseases

A 30-year-old woman presents with a breast abscess 3 weeks postpartum. She is breastfeeding. Ultrasound confirms a 4 cm collection. Gram stain shows Gram-positive cocci in clusters. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Ultrasound-guided needle aspiration (or incision and drainage if large) plus oral Flucloxacillin; continue breastfeeding

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

Lactational breast abscess >3 cm typically requires drainage (ultrasound-guided aspiration is first-line; I&D for large or recurrent abscesses) plus oral Flucloxacillin 500 mg QDS for 7–14 days (S. aureus is the most common pathogen). Breastfeeding should CONTINUE on both sides — it helps drain the breast and does not harm the infant (unless the abscess is directly at the nipple). MRSA should be considered if no response; send aspirate for culture. Co-amoxiclav is an alternative if mixed organisms are suspected.

Reference: NICE CKS 2024 – Breast abscess; RCM 2023 – Breastfeeding and mastitis