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[Mammography in the diagnosis and treatment of non-puerperal mastitis (author's transl)].

Circumscribed or diffuse non-puerperal mastitis is usually associated with local signs of inflammation. In two-thirds of these cases it is possible to demonstrate the radiological features of mastitis. Mammography is an important diagnostic procedure in the demonstration of acute mastitis and its differentiation from an inflammatory carcinoma; it is also valuable in the control of treatment. The success of intensive antibiotic therapy with recovery of normal appearances in the chest can be observed objectively by mammography. In distinguishing mastitis from an inflammatory carcinoma, radiological evidence of regression under the influence of antibiotics is evidence in favour of mastitis.

Adult↗

[The value of MR-mammography at 1.5 tesla in the differential diagnosis of non-puerperal mastitis and inflammatory breast carcinoma].

PURPOSE: The distinction between mastitis and inflammatory breast carcinoma is an important one. Current methods of evaluation including mammography, ultrasound and clinical examination do not enable this distinction. Dynamic magnetic resonance mammography (MRM) is a study with potential in this regard. MATERIAL AND METHODS: 12 patients, in whom clinical examination, mammography and ultrasound could not distinguish between both diseases, were reviewed retrospectively by means of MRM using a 1.5 T Siemens Magnetom SP and a circular mamma coil. We used dynamic 3-D gradient echo sequences with a duration of one minute. RESULTS: At present MRM cannot definitely distinguish between mastitis and inflammatory carcinoma, 80% of the inflammatory carcinomas were found to enhance more than 100% in the first minute, compared to 43% for mastitis. No other differences were seen. CONCLUSION: MRM proved useful in the follow-up of treated mastitis to demonstrate the success of antibiotic treatment of mastitis and to diagnose a histologically unconfirmed inflammatory carcinoma by means of a different follow-up.

Adenocarcinoma↗

[Hand disinfection as the central factor in prevention of puerperal mastitis. Clinical study and results of a survey].

The incidence of puerperal mastitis was evaluated in the course of two 12-month periods with and without additional hand disinfection at the bedside. Disinfection was available throughout both periods for all patients, mounted at the door of each room. Without additional disinfection at the bedside, 32 patients developed mastitis. With reference to the birth rate of 1095 during this period, the incidence of mastitis was 2.9%. When additional bedside disinfection was available, mastitis dropped to 8 cases per 12 months (1212 births = 0.66%) (p less than 0.001). A telephone survey, at 55 obstetrical units revealed that 41.8% of maternity clinics do not provide hand disinfectants at the bedside. These results indicate to the breast-feeding mother, that in the pathogenesis of puerperal mastitis, the essential recommendation emphasises, that puerperal women practise strict hygiene in maternity.

Breast Feeding↗

[Nonpuerperal mastitis].

The medical history of 37 women with nonpuerperal mastitis, who had been treated between January 1980 and July 1983 at the Dept. of Obstetrics and Gynaecology of the University of Tübingen, was reviewed because of the increasing prevalence of this disease. Defined by different history and clinical symptoms, two groups of patients were seen: 25 women with acute nonpuerperal mastitis and 12 women with chronic recurring nonpuerperal mastitis. The average age of the patients was 30 years. The inflammation was located mostly subareolar and around the nipple. The main symptoms were pain, erythema and swelling, in acute cases accompanied by fever and abscess formation. This process was strongly related to the interval between the onset of symptoms and the initiation of treatment. Anaerobes and Staphylococcus aureus could be cultured mainly from women with acute nonpuerperal mastitis. In females with chronic recurrent mastitis, mostly anaerobes were found. Women were treated with a prolactin inhibitor (bromocriptine), if abscess formation, leukocytosis or fever were absent. In patients with leukocytosis and/or fever this regimen was combined with antibiotics. Abscesses were treated surgically, in some cases in combination with prolactin inhibition and antibiotic administration. The results show that an early conservative treatment is important to prevent abscess formation. It seems that this treatment can reduce the rate of recurrences.

Abscess↗

Evidence that bovine forebrain embryonic zinc finger-like gene influences immune response associated with mastitis resistance.

Mastitis, a mammary gland inflammation in response to bacterial infection, is a major problem in the dairy industry. We found that cows susceptible to mastitis have a three-base insertion in a glycine-coding stretch of the gene for forebrain embryonic zinc finger-like (FEZL), a transcription factor with a role in neuronal development. Mastitis induces FEZL expression in mammary glands, and induced FEZL promotes expression of the axon-attracting molecule semaphorin 5A (SEMA5A) through a GCAG sequence. FEZL also induces SEMA5A expression in susceptible cattle but at a lower level than in resistant cattle. Enhanced SEMA5A induces expression of at least nine genes related to the host's immune response, including TNF-alpha and IL-8. We propose that susceptibility to mastitis results from an impaired immune response due to the lower transcription activity of susceptible FEZL. Our results provide an avenue to select for genetic improvement of resistance to mastitis and suggest that the FEZL-SEMA5A pathway might control both neuronal development and innate immunity.

Adaptor Proteins, Vesicular Transport↗

Fourier transform infrared spectroscopic analysis of organic oil mastitis.

The prevalent use of "medical grade" silicone oils, gels, and elastomers in medical practice has largely obscured the fact that other (illicit) materials also are still in use. Injection fluids used for tissue augmentations are sometimes composed of adulterated silicone oil formulations containing a variety of organic oils. The differential diagnosis between silicone mastitis and other organic oil mastitis in biopsy and mastectomy specimens cannot be resolved by oral history and histopathologic examination alone. In two of three specimens clinically and histopathologically diagnosed initially as silicone mastitis at the authors' institution, examination by Fourier transform infrared spectroscopy revealed that the principal organic oils were mineral oil and soy or olive oil. Only one specimen of mastitis contained silicone oil. In view of the significant prognostic as well as medicolegal implications of the pathologic diagnosis, the generic term "organic oil mastitis" should be used in the absence of additional objective data.

Female↗

Bovine mastitis caused by Listeria monocytogenes: characteristics of natural and experimental infections.

Experimental mastitis induced with a single intramammary injection of Listeria monocytogenes was compared with two naturally occurring cases. Four strains of L. monocytogenes, two of serotype 1/2a and two of serotype 4b were used for the experimental infections and two diametrically opposed quarters of four cows were inoculated with 300 cfu. Bacteriological examination and somatic cell counts of quarter foremilk samples were performed weekly for at least 6 months after challenge. All the inoculated quarters developed chronic subclinical mastitis with occasional clinical episodes. The results were similar to those observed in natural listeria mastitis. Four experimentally infected quarters were treated during lactation (gentamicin and cloxacillin) or at "drying-off" (cloxacillin), or at both times. Only one of four quarters was cured after treatment only at "drying-off". All experimental and naturally infected animals were slaughtered and bacteriological examination was performed on liver, spleen and supramammary, iliac and mesenteric lymph nodes. L. monocytogenes strains were isolated from the supramammary lymph nodes of two experimentally and two naturally infected cows and from an iliac lymph node from one of the naturally infected cows. The epidemiological data were supported by serotyping, lysotyping and DNA macro-restriction analysis. The experimental model of listeria mastitis mimics spontaneous cases and should be useful in further studies of listeria mastitis.

Animals↗

A study on association between mastitis and serologically defined class I bovine lymphocyte antigens (BoLA-A) in Norwegian cows.

A total of 102 cows was tested for class I antigens of the bovine major histocompatibility complex. Half of the animals (51) had completed at least four lactations without any veterinary treatment for mastitis. The distribution of BoLA-A antigens among these relative mastitis-resistant cows was compared to that in the other half of the material (51), which comprised animals with at least one recorded treatment for mastitis. There were no statistically significant differences in BoLA-A antigen frequency between cows with mastitis and cows without mastitis. The two most common antigens were A2 and w16. The frequency of these two antigens deviated from earlier estimates within the Norwegian cattle (NRF) population, the difference for w16 being statistically significant.

Animals↗

Studies on the possible role of cattle nuisance flies, especially Hydrotaea irritans, in the transmission of summer mastitis in Denmark.

The summer mastitis pathogens Actinomyces pyogenes, Peptococcus indolicus, Bacteroides melaninogenicus ss. levii, Fusobacterium necrophorum and Streptococcus dysgalactiae were isolated from the polyphagous symbovine dipterans Hydrotaea irritans (Fallén) and Morellia sp. caught around dairy heifers on pasture, but not from the haematophagous species Haematobia irritans (L.), Haematobosca stimulans (Meigen), Culicoides sp. and Simulium sp. Secretions from clinical cases of summer mastitis proved to be sources of summer mastitis bacteria for more than 3 weeks despite antibiotic treatment and teat amputation. Taking into account the seasonal activity pattern of Hydrotaea irritans and its topographical distribution on grazing cattle, it appears evident that this fly may play a central role in the establishment and maintenance of the bacterial contamination with summer mastitis pathogens on the teats of healthy cattle. In the present study the survival of A.pyogenes and P.indolicus for 7 days in experimentally infected Hydrotaea irritans, as demonstrated by the recovery of these microorganisms from agar plates exposed to live infected flies, is described. However, experimental transmission of summer mastitis from sick to healthy heifers by Hydrotaea irritans proved unsuccessful.

Actinomyces↗

Summer mastitis experimentally induced by Hydrotaea irritans exposed to bacteria.

Summer mastitis is an acute suppurative bacterial infection of the udder in heifers and dry cows. To ascertain the possible role of flies in the transmission of the disease, experimental exposures of recipient heifers to Hydrotaea irritans previously exposed to bacteria were carried out. Flies were allowed to feed on secretions from clinical cases of summer mastitis. The pathogens present were the bacteria Staphylococcus aureus, Streptococcus dysgalactiae, Actinomyces pyogenes, Stuart-Schwan cocci, Peptococcus indolicus, Fusobacterium necrophorum and Bacterioides species. The teats of eight heifers were exposed to flies with verified pathogen content. Two teats of each animal were deliberately damaged before fly exposure. One teat was cut, another pricked with insect needles to mimic insect bites. Two of the heifers developed summer mastitis in the quarters where teats had been cut. The bacterial species isolated from these quarters corresponded to those that had previously been fed to the flies. For the first time, it is now demonstrated that H.irritans is capable of transmitting summer mastitis pathogens and so causing summer mastitis in recipient heifers. Lesions on the teat orifice may be a predisposing factor in the development of the disease.

Animals↗

Mycoplasma mastitis: a review of transmission and control.

The Mycoplasma sp. that cause mastitis are simple, cell wall-less, bacteria that can colonize and cause diseases in other extramammary sites in the bovine. Prevalence of mycoplasma mastitis appears to be increasing in many locations throughout the world. The best method to identify this group of pathogens is through direct culture on mycoplasma agar media. However, limitations with this culture procedure are the duration of culture, 10 days, special conditions required and thus added expense, and the lack of primary specificity to distinguish between true pathogens and commensal organisms. Thus culture of bulk tank milk samples has been advocated as a primary screening method to determine the mycoplasma status of a herd. This monitoring system is reasonably successful but the sensitivity of detection of Mycoplasma sp. in bulk tank milk is affected by a significant minority of cows that might shed the organism at levels below the threshold of detection. Contagious mastitis control procedures have been effective in controlling outbreaks of mycoplasma mastitis. Yet new methods of control might be warranted, methods that may prevent the outbreak. Current data suggests that a significant number of new outbreaks may occur via internal or animal-to-animal transmission of mycoplasma mastitis pathogens from asymptomatic carriers.

Animals↗

Normal somatic cell count and subclinical mastitis in Murrah buffaloes.

This study was conducted to investigate the normal somatic cell count (SCC) and to define subclinical mastitis in Murrah buffaloes. Data were collected from 60 clinically normal buffaloes stationed at five farms of Chitwan Nepal and Buffalo Research Center, Hissar, India. Somatic cell count was measured using the Newman-Lampert staining technique. The upper limit of SCC was determined >or=200 000/ml of milk based on the mean +/- 2SD of a total SCC. Abnormal data of the SCC was repeatedly removed, which lie beyond the values of more than mean + 2SD until all the data come to lie within (mean + 2SD). Averages of SCC of right front and right hind quarters were significantly higher than left front and left hind quarters. Nearly 94% of California mastitis test (CMT) negative quarters were having somatic cells >or=200 000/ml. The mean SCC of CMT positive quarter was significantly higher (P < 0.01) than CMT negative quarters. Subclinical mastitis was diagnosed on the basis of samples with SCCs >or=200 000/ml with positive bacterial cultures. Subclinical mastitis was found in 21.7% buffaloes and 8% of the quarter foremilk samples. Neutrophil counts were significantly higher in subclinical mastitis milk.

Animals↗

Mastitis and transmission of human immunodeficiency virus through breast milk.

Mastitis, an inflammation in the breast, has recently been linked with higher human immunodeficiency virus (HIV) load in breast milk and higher risk of mother-to-child transmission of HIV. Among 334 HIV-infected women in Malawi who were breastfeeding, the prevalence of mastitis, as indicated by elevated breast milk sodium, was 16.4% at six weeks and 2.8% at six months postpartum. Mastitis is associated with significantly higher concentrations of immunological and inflammatory mediators in breast milk, including lactoferrin, lysozyme, secretory leukocyte protease inhibitor, interleukin-8, and RANTES. Mastitis is potentially preventable by improving micronutrient status of breastfeeding women and can be treated with antibiotics and clinical management. These studies in Malawi suggest that mastitis may contribute to transmission of HIV through breast milk.

Acquired Immunodeficiency Syndrome↗

Molecular analysis of Pseudomonas aeruginosa: epidemiological investigation of mastitis outbreaks in Irish dairy herds.

Pseudomonas aeruginosa is a pathogen in both humans and animals. This bacterium, most often associated with respiratory infections in cystic fibrosis patients, was found to be the causative agent in bovine mastitis outbreaks among 11 Irish dairy herds. Epidemiological findings suggested that the infection was spread to all herds by teat wipes that had been contaminated with this organism. Two molecular-typing strategies were used in an attempt to determine the genomic relationship(s), if any, of the P. aeruginosa strains isolated from the various herds and to verify whether the same strain was responsible for each outbreak. Thirty-six isolates from the mastitis outbreaks were tested and compared to fourteen clinical isolates from Cork University Hospital. With one exception, all outbreak-linked strains produced identical patterns when ribotyped with ClaI and PvuII enzymes. Eight of the clinical isolates gave the same ClaI ribotype pattern as the mastitis-causing strains. However, PvuII proved more discriminatory, with only the outbreak isolates producing identical patterns. Similar results were obtained with RW3A-primed DNA amplification fingerprinting, with all outbreak isolates except one displaying the same fingerprint array. The clinical strains produced several fingerprint patterns, all of which were different from those of the mastitis-causing isolates. Fine-resolution DNA fingerprinting with a fluorescence-labelled RW3A primer also identified a number of low-molecular-weight polymorphisms that would have remained undetected by conventional methods. These data support the view that the same P. aeruginosa strain was responsible for the mastitis outbreaks in all 11 herds.

Animals↗

Development of a rapid and sensitive test for identification of major pathogens in bovine mastitis by PCR.

Bovine mastitis is the most important source of loss for the dairy industry. A rapid and specific test for the detection of the main pathogens of bovine mastitis is not actually available. Molecular probes reacting in PCR with bacterial DNA from bovine milk, providing direct and rapid detection of Escherichia coli, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus parauberis, and Streptococcus uberis, have been developed. Two sets of specific primers were designed for each of these microorganisms and appeared to discriminate close phylogenic bacterial species (e.g., S. agalactiae and S. dysgalactiae). In addition, two sets of universal primers were designed to react as positive controls with all major pathogens of bovine mastitis. The sensitivities of the test using S. aureus DNA extracted from milk with and without a pre-PCR enzymatic lysis step of bacterial cells were compared. The detection limit of the assay was 3.125 x 10(2) CFU/ml of milk when S. aureus DNA was extracted with the pre-PCR enzymatic step compared to 5 x 10(3) CFU/ml of milk in the absence of the pre-PCR enzymatic step. This latter threshold of sensitivity is still compatible with its use as an efficient tool of diagnosis in bovine mastitis, allowing the elimination of expensive reagents. The two PCR tests avoid cumbersome and lengthy cultivation steps, can be performed within hours, and are sensitive, specific, and reliable for the direct detection in milk of the six most prevalent bacteria causing bovine mastitis.

Animals↗

Granulomatous lobular mastitis.

The clinical and pathological features of nine cases of granulomatous mastitis were compared with those of 10 cases of duct ectasia/periductal mastitis (DE/PM), all of which were associated with active granulomatous inflammation. Granulomatous mastitis affects a younger age group, and although there is some overlap with DE/PM, it has distinctive pathological features, particularly a lobule centred distribution, for which the term "granulomatous lobular mastitis" is recommended. There is a strong tendency for persistence or recurrence. Our cases of granulomatous mastitis all occurred in parous women, five of them within three years of pregnancy. Awareness of this condition is important, because surgery does not offer the best treatment of recurrent disease, and trials of adequate drug treatment, including corticosteroids, are required.

Adolescent↗

A survey of mastitis in the British dairy herd.

Five hundred herds were examined to determine the prevalence of subclinical mastitis in the British dairy herd. The prevalences of the various infections recorded were Streptococcus agalactiae 3.4 per cent of quarters, S dysgalactiae 1.1 per cent, S uberis 1.5 per cent and Staphylococcus pyogenes 8.1 per cent. There were regional differences in the prevalence of some of these pathogens. The national prevalence of subclinical mastitis as defined by the International Dairy Federation was 9.6 per cent of all quarters. Udder infections were less prevalent in herds where mastitis control measures were being used. The prevalence of infection also declined as the size of herd increased. However, as the uptake of mastitis control measures was greater in the larger herds it seems likely that the widespread use of control measures was the most important factor responsible for the relatively low prevalence of subclinical mastitis.

Animals↗

Observations on the incidence of clinical bovine mastitis in non-lactating cows in England and Wales.

Epidemiological features of clinical mastitis in dry cows from a three year prospective study are described. Two hundred and seventy-three herds in England and Wales participated in the first year (1980) and 209 and 159 of them continued in the study in the subsequent two years. Clinical mastitis was recorded in 1.5 per cent of cows during the dry period in each of the three years. These cases represented between 3.6 and 4.2 per cent of samples from all clinical cases examined. The incidence of clinical mastitis in dry cows increased during the winter housing period (October to March), a peak occurring at the end of this period. A secondary peak in incidence was recorded in August. Streptococcus uberis was the predominant pathogen. Variations in the monthly incidences of cases associated with the major mastitis pathogens were observed. A greater proportion of cases which occurred during the dry period exhibited systemic signs than of cases which occurred during lactation, with the exception of cases associated with Escherichia coli. The risk of clinical mastitis was apparently higher during the last 30 days of the dry period than during the earlier stages of the dry period.

Animals↗