Treatment of Infected Nipple Discharge

Distinguishing Purulent from Other Discharge Types

• Pathologic discharge, which is spontaneous, unilateral, single-duct, and bloody or serous, raises concern for malignancy and differs from purulent discharge, according to the American College of Radiology 1, 2, 3

Treatment Algorithm for Infected Nipple Discharge

Special Considerations for Patient Care

• The American College of Radiology recommends diagnostic mammography and ultrasound for women ≥40 years with pathologic discharge, and ultrasound alone for women <30 years, with either mammography or ultrasound initially for ages 30-39 years 1, 5
• Patients with purulent discharge should not be assumed to have infection as the sole explanation, and more aggressive treatment may be required in certain contexts, such as widespread impetigo vulgaris or severe presentation, as suggested by clinical guidelines 4