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Curr Microbiol (2009) 59:5964
DOI 10.1007/s00284-009-9393-z
Bacterial Analysis of Breast Milk: A Tool to Differentiate Raynauds Phenomenon from Infectious Mastitis During Lactation
Susana Delgado M. Carmen Collado Leonides Fernndez Juan M. Rodrguez
Received: 16 December 2008 / Accepted: 25 February 2009 / Published online: 28 March 2009 Springer Science+Business Media, LLC 2009
Abstract Lactational Raynauds syndrome may be mis-diagnosed as infectious mastitis on the basis of the breast pain. The objective of this work was to elucidate if microbiological analysis of milk may contribute to the differentiation of both conditions. Ten lactating women clinically diagnosed by Spanish lactation consultants were included in the study. Of these, ve suffered from mastitis and the remaining ve suffered from Raynauds syndrome. Breast milk samples were inoculated on diverse culture media. Seventy isolates were selected and identied by 16S rDNA PCR sequencing. Parallel, PCR-DGGE and quantitative real-time PCR were used to assess the presence of bacterial DNA in the samples. Neither bacteria nor yeasts could be detected in the milk samples provided by the women suffering from Raynauds syndrome. In contrast, large numbers of bacteria were isolated from those with infectious lactational mastitis. Globally, the levels of bacterial DNA were signicantly higher in the milk of mastitis-suffering women. Bacteriological analysis of milk can be an useful tool to facilitate the differential diagnosis between the infectious mastitis and Raynauds syndrome during lactation.
Introduction
Raynauds Syndrome (RS) was described originally as a vasospasm of the arterioles of terminal parts of the body,
such as ngers and toes [17]. Since 1992, when it was suggested that nipple vasospasm could be related to RS [2], several cases associated with painful breastfeeding have been reported [1, 7, 13]. Raynauds phenomenon seems relatively common in healthy women of childbearing age, affecting up to 22% of healthy women in the 2150 year age group [15].
Diagnostic and treatment of nipple or breast infection in breastfeeding women is complicated by the variety of symptoms women experience and RS may be misdiagnosed as candidiasis or infectious mastitis on the basis of the severe breast pain [21]. As a consequence, women with this syndrome are often treated inappropriately with topical and/or systemic antibiotics and/or antifungal agents. In fact, since no relief is obtained, they use to be submitted to...