O91.013 Infection of nipple associated with pregnancy, third trimester

Name of the Condition

• Infection of Nipple Associated with Pregnancy, Third Trimester (O91.013)

Summary

Infection of the nipple associated with pregnancy, third trimester, is a localized infection occurring during the third trimester of pregnancy. It typically involves bacterial or fungal pathogens and may present as inflammation, pain, or discharge. Prompt recognition and treatment are important to prevent progression and ensure maternal comfort.

Causes

The condition is commonly caused by bacterial organisms, such as Staphylococcus aureus or Streptococcus species, which can enter through cracked or damaged nipple skin. Fungal infections, like Candida, may also occur. Poor hygiene, trauma to the nipple, or hormonal changes during pregnancy can contribute to infection development.

Risk Factors

• Cracked or damaged nipples from pregnancy-related changes.
• Poor hygiene practices.
• History of previous breast infections.
• Use of tight-fitting or non-breathable clothing.
• Underlying skin conditions or immunosuppression.

Symptoms

• Pain, tenderness, or swelling of the nipple.
• Redness or warmth in the affected area.
• Discharge (pus or fluid) from the nipple.
• Itching or burning sensation, especially with fungal infections.
• Fever or systemic symptoms in severe cases.

Diagnosis

Diagnosis is primarily clinical, based on symptoms and physical examination. Cultures of nipple discharge may be taken to identify the causative organism. Imaging, such as ultrasound, may be used to assess for abscess formation or deeper tissue involvement.

Treatment Options

Treatment typically includes topical or systemic antibiotics for bacterial infections, antifungal medications for fungal infections, and pain management. Good hygiene practices and nipple care are also recommended. Severe cases may require drainage of abscesses or additional interventions.

Prognosis and Follow-Up

With appropriate treatment, most cases resolve without complications. Follow-up may involve monitoring for recurrence or progression to mastitis. Patients should be advised to seek care if symptoms worsen or persist.

Complications

Untreated infections may progress to mastitis, abscess formation, or systemic infection. Chronic pain or scarring of the nipple may occur in severe cases.

Lifestyle & Prevention

• Maintain good nipple hygiene during pregnancy.
• Use breathable clothing to reduce moisture.
• Avoid trauma or excessive friction to the nipples.
• Seek prompt care for cracked or damaged nipples.

When to Seek Professional Help

Seek medical attention if symptoms worsen, fever develops, or discharge becomes persistent or bloody. Early evaluation is important to prevent complications.

Tips for Medical Coders

Document the trimester (third trimester) and confirm the infection is associated with pregnancy. Ensure clinical documentation supports the diagnosis and links the infection to the pregnancy context. Code O91.013 is specific to the third trimester; verify timing and association with pregnancy in the record.