Question

A 23 year old G2P2 presents on postpartum day 10 with fever and a tender left breast. Her symptoms began two days ago, and have been accompanied by myalgias, chills, and malaise. She has been breastfeeding her new daughter, and reports that this has been going well, and that her child has appeared healthy since birth. Vital signs include temperature 38.4 C (101.1 F), pulse 90, and blood pressure 112/68. On physical examination, the patient's left breast is erythematous and engorged, and very tender to palpation. No masses or areas of fluctuance are appreciated. The right breast is unremarkable. Which of the following is the most appropriate initial step in the management of this patient?

A. Incision and drainage
B. Mammography
C. Tetracycline
D. Dicloxacillin
E. Cephalexin and temporary cessation of breastfeeding

Answer 1

For a breast-feeding mother with mastitis, the most appropriate management is to begin treatment with a course of antibiotics such as Dicloxacillin, and continue breastfeeding or pumping to maintain milk flow.

Step-by-step explanation:

The 23-year-old G2P2 who presents with a fever and a tender left breast on postpartum day 10 is showing signs of mastitis, which is an infection of the breast tissue. Based on the description, the most appropriate initial step in the management of this patient would be to prescribe a course of antibiotics that are safe for breastfeeding mothers. The correct choice would be D. Dicloxacillin, which is usually the first line of treatment for mastitis. It is crucial to continue breastfeeding or pumping to maintain milk flow while undergoing antibiotic treatment. Cessation of breastfeeding is not recommended as it may exacerbate breast engorgement and can lead to abscess formation.