History of Present Illness (HPI)

The patient presents with a complaint of a painful, sore area in the right breast that is tender and warm to the touch, with symptoms lasting for 1 day. The patient has a history of recurrent cellulitis, with the last episode occurring 9 months ago.

Differential Diagnosis

• Single Most Likely Diagnosis
  • Cellulitis: Given the patient's history of recurrent cellulitis and the presentation of a tender, warm area in the breast, cellulitis is the most likely diagnosis. The symptoms of pain, tenderness, and warmth are consistent with an infectious process.
• Other Likely Diagnoses
  • Mastitis: This is an inflammation of the breast tissue, which can be infectious or non-infectious. The patient's symptoms could be consistent with mastitis, especially if there is an infectious component.
  • Breast Abscess: A collection of pus in the breast tissue, which can cause pain, tenderness, and warmth. Given the patient's history of recurrent infections, a breast abscess is a possible diagnosis.
  • Inflammatory Breast Cancer: Although less likely, inflammatory breast cancer can present with similar symptoms, including pain, tenderness, and warmth of the breast.
• Do Not Miss Diagnoses
  • Necrotizing Fasciitis: A severe, life-threatening infection that can cause pain, tenderness, and warmth. Although rare, it is crucial to consider this diagnosis due to its high morbidity and mortality.
  • Sepsis: If the infection is severe, it could lead to sepsis, a life-threatening condition that requires immediate attention.
• Rare Diagnoses
  • Granulomatous Mastitis: A rare inflammatory condition of the breast that can cause pain, tenderness, and warmth.
  • Mondor's Disease: A rare condition characterized by thrombophlebitis of the superficial veins of the breast, which can cause pain and tenderness.