What is the diagnosis for a 32-year-old woman, gravida 1 para 1, presenting with left breast pain, erythema, and fluctuance, accompanied by fever and axillary lymphadenopathy, six weeks postpartum, while continuing to breastfeed from the unaffected breast?

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Differential Diagnosis for Breast Pain and Erythema in a Postpartum Woman

  • Single most likely diagnosis:
    • Breast abscess: This is the most likely diagnosis given the patient's symptoms of breast pain, erythema, and a well-circumscribed area of fluctuance, which are classic signs of a breast abscess. The patient's recent history of breastfeeding also increases the risk of developing a breast abscess.
  • Other Likely diagnoses:
    • Mastitis: This is an inflammation of the breast tissue, often caused by infection, and is a common condition in breastfeeding women. The patient's symptoms of breast pain, erythema, and fever are consistent with mastitis.
    • Cellulitis: This is a bacterial infection of the skin and subcutaneous tissue, which could explain the patient's symptoms of erythema, warmth, and swelling.
    • Plugged duct: This is a common condition in breastfeeding women, where a milk duct becomes blocked, leading to pain, swelling, and erythema.
  • Do Not Miss diagnoses:
    • Inflammatory breast cancer: Although rare, this aggressive form of breast cancer can present with similar symptoms to mastitis or a breast abscess, including erythema, warmth, and swelling. It is essential to consider this diagnosis to avoid delayed treatment.
    • Necrotizing fasciitis: This is a rare but life-threatening infection that can occur in the breast tissue, characterized by severe pain, erythema, and swelling.
  • Rare diagnoses:
    • Granulomatous mastitis: This is a rare inflammatory condition of the breast, characterized by granulomatous inflammation, which can present with similar symptoms to mastitis or a breast abscess.
    • Breast cyst or galactocele: These are benign conditions that can cause breast pain and swelling, but are less likely to present with erythema and fever.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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