O91.113 Abscess of breast associated with pregnancy, third trimester

Name of the Condition

• Abscess of Breast Associated with Pregnancy, Third Trimester (O91.113)

Summary

This condition involves a localized collection of pus within breast tissue during the third trimester of pregnancy. It typically results from a bacterial infection and may present as a painful, swollen area. Prompt medical evaluation is necessary to manage symptoms and prevent complications.

Causes

Abscesses often develop when bacteria, such as Staphylococcus aureus, enter the breast tissue through a break in the skin or milk ducts. Hormonal changes during pregnancy can increase susceptibility, and inadequate milk drainage or engorgement may contribute to infection progression.

Risk Factors

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

Symptoms

• Breast pain, swelling, or redness.
• Fever or chills.
• Palpable, tender lump with fluctuance.
• Nipple discharge or pus.
• Skin warmth or discoloration over the affected area.

Diagnosis

Diagnosis is based on clinical evaluation, including physical examination for signs of abscess formation. Ultrasound may be used to confirm the presence and extent of the abscess. Cultures of discharge or aspirated fluid may identify the causative organism.

Treatment Options

Treatment typically involves drainage of the abscess, often with antibiotic therapy to address the underlying infection. Pain management and supportive care may also be provided. In some cases, surgical intervention may be necessary.

Prognosis and Follow-Up

With appropriate treatment, most abscesses resolve without long-term complications. Follow-up care ensures complete healing and monitors for recurrence. Patients should be advised on proper breastfeeding techniques and hygiene to prevent future infections.

Complications

• Spread of infection to surrounding tissue.
• Recurrent abscess formation.
• Mastitis or cellulitis.
• Delayed wound healing.

Lifestyle & Prevention

• Maintain good breast hygiene.
• Ensure proper milk drainage to prevent engorgement.
• Use lanolin or nipple cream to treat cracked nipples.
• Wear loose-fitting, breathable clothing.
• Practice regular handwashing before breastfeeding.

When to Seek Professional Help

Seek medical attention if symptoms worsen, fever persists, or the abscess does not improve with initial care. Signs of spreading infection, such as increasing redness or systemic symptoms, require prompt evaluation.

Tips for Medical Coders

Document the trimester (third trimester) and confirm the abscess is associated with pregnancy. Ensure clinical notes support the diagnosis and any interventions performed. Code O91.113 is specific to the third trimester; verify timing aligns with documentation.