Objective: Infection of breast tissue (mastitis) is a rare infection occurs in neonates. There are several factors contribute to potential pathogenic bacterial growth in skin and mucosa such as; mother’s genital flora, baby’s nutrition, and direct contact. Several management approach can be applied. We present case of neonatal mastitis with suspicious food allergy as exaggerating factor and its respond to conservatives management.
Case: A 13 days old female baby came to the emergency with engorgement and redness in the right breast. The baby, previously, observed at the polyclinic and there’s sign of mastitis with necrotic component without prominent abscess from breast ultrasonography. The patient then prescribed with ampicillin/sulbactam and referred to the hospital for surgery. Patient came to emergency and examined. At the physical examination, there was engorgement and redness extended to the area around the breast approximately 1.5 cm in the diameter with blurry boundaries. From the laboratory examination, there was increase above normal limit in CRP level 13.6mg/L and procalcitonin level 1.94. The blood culture appeared negative. The patient admitted to the neonatal ward. In the further evaluation, patient’s had been consuming breast milk from mother that had been consuming 6 to 8 eggs everyday and cow’s milk product after C-section. We prescribed oral clindamycin and informed mother to avoid cow’s milk product and stop consuming excessive eggs. At the third day, the site of engorgement is getting localized and smaller with diameter 0.5 cm. Oral clindamycin continue up to 10 days and no surgery needed.
Conclusion: Early diagnosis should be performed to be able to give appropriate treatment and prevent complication. Conservatives management, with oral antibiotic and avoid exaggerating factor such as food allergy, approach still suitable in the approach treatment of neonatal mastitis.