Discharge From Nipple For Culture And Sensitivity

Function

This test involves collecting fluid discharged from the nipple to identify pathogenic bacteria or fungi through culture. Once an organism is grown, 'sensitivity' testing is performed to determine which specific antibiotics will effectively kill the pathogen.

Why it is Ordered

It is primarily ordered when a patient has nipple discharge that is purulent (pus-like), foul-smelling, or associated with breast pain, redness, or warmth—all signs of mastitis or a breast abscess. It helps clinicians differentiate between an infectious cause and non-infectious causes like hormonal imbalances (galactorrhea) or ductal ectasia.

Associated Conditions

• Lactational Mastitis: Common in breastfeeding women due to skin bacteria entering the milk duct.
• Breast Abscess: A localized collection of pus requiring drainage and targeted antibiotics.
• Subareolar Abscess: Often associated with smoking and squamous metaplasia of the lactiferous ducts.
• Periductal Mastitis: Inflammation of the ducts usually seen in non-lactating women.

Clinical Management

Identifying the specific organism (e.g., Staphylococcus aureus, Streptococcus, or anaerobes) is crucial, especially as antibiotic resistance (like MRSA) becomes more common. The sensitivity report allows the physician to switch from broad-spectrum 'best guess' antibiotics to targeted therapy, ensuring faster resolution and preventing recurrence.