O91 Infections of breast associated with pregnancy, the puerperium and lactation

Name of the Condition

• Infections of Breast Associated with Pregnancy, the Puerperium and Lactation (O91)

Summary

This condition involves bacterial or other infections of the breast that occur during pregnancy, the postpartum period (puerperium), or while breastfeeding. These infections can affect the breast tissue, milk ducts, or surrounding areas and may require medical intervention to prevent complications.

Causes

Infections typically result from bacteria entering the breast tissue, often through cracked or damaged nipples during breastfeeding. Staphylococcus aureus is a common causative organism. During pregnancy or the puerperium, hormonal changes and milk stasis can increase susceptibility to infection.

Risk Factors

• Cracked or sore nipples during breastfeeding.
• Inadequate milk removal or engorgement.
• Previous breast infections.
• Poor hygiene practices.
• Weakened immune system.

Symptoms

• Breast pain, swelling, or redness.
• Fever or chills.
• Nipple discharge or pus.
• Hard, tender lump in the breast.
• Flu-like symptoms in severe cases.

Diagnosis

Diagnosis is based on clinical evaluation, including physical examination of the breast for signs of infection. Cultures of breast milk or discharge may be taken to identify the causative organism. Imaging, such as ultrasound, may be used to assess for abscess formation.

Treatment Options

• Antibiotics: Prescribed to treat bacterial infections, often targeting common pathogens like Staphylococcus aureus.
• Drainage: Surgical or needle aspiration for abscesses.
• Supportive care: Pain relief, warm compresses, and continued breastfeeding (if feasible) to maintain milk flow.

Prognosis and Follow-Up

With prompt treatment, most infections resolve without long-term issues. Follow-up may involve monitoring for recurrence or complications. Severe cases or those with abscesses may require extended care.

Complications

• Abscess formation requiring drainage.
• Recurrent infections.
• Mastitis spreading to surrounding tissue.
• Rarely, sepsis in severe untreated cases.

Lifestyle & Prevention

• Maintain good nipple hygiene.
• Ensure proper breastfeeding technique to prevent nipple damage.
• Empty breasts regularly to avoid milk stasis.
• Wear loose-fitting, breathable clothing.

When to Seek Professional Help

Seek care if symptoms worsen, fever persists, or a lump becomes increasingly painful or does not improve with home care. Immediate attention is needed for signs of systemic infection, such as high fever or chills.

Tips for Medical Coders

Document the timing (pregnancy, puerperium, or lactation) and clinical findings (e.g., abscess, cellulitis) to support code assignment. Ensure differentiation from non-infectious breast conditions.