Leukocyte counts and microbiologic cultivation in the diagnosis of puerperal mastitis.

In order to study the value of leukocyte counts and quantitative microbiologic cultivation of milk in the diagnosis of puerperal mastitis, 491 milk samples from nursing women were examined. In milk samples from mammary glands without inflammatory symptoms, leukocyte counts were less than 10(6)/ml of milk, and the milk was sterile or harbored less than 10(3) bacteria/ml. Samples from mammary glands with inflammatory symptoms could be divided into three groups. In one group, leukocyte counts were less than 10(6)/ml of milk, and cultivation results were similar to those of mammary glands without symptoms. The symptoms persisted for an average of 2.1 days. These cases were considered as milk stasis. In another group, the leukocyte counts were greater than 10(6)/ml of milk, but the milk was sterile or contaminated by skin flora bacteria. Average duration of symptoms was 5.3 days. These cases were considered as noninfectious inflammation of the breast. In the third group, leukocyte counts were greater than 10(6)/ml of milk and bacteria occurred in numbers of greater than 10(3)/ml, which suggests the presence of infectious mastitis. In these cases only antibiotic treatment should be recommended.