Abstract / Summary
Antibioma of the breast is a chronic inflammatory pseudotumour that forms when a breast abscess undergoes partial sterilisation by antibiotic therapy in the absence of surgical drainage. It remains poorly documented, and reports involving non-lactating women are scarce. A 22-year-old non-lactating woman presented with a two-month history of left retroareolar breast swelling that had not responded to sequential courses of oral second- and third-generation cephalosporins. Examination revealed a 4×3 cm retroareolar mass with nipple retraction and erythema, raising clinical concern for inflammatory breast carcinoma. Breast ultrasonography confirmed a 3.4×2.2 cm hypoechoic collection with internal debris. Culture from ultrasound-guided aspiration grew Methicillin-resistant Staphylococcus aureus (MRSA), resistant to the beta-lactam agents used in both prior courses and susceptible to ciprofloxacin, which explained the earlier treatment failures. Cytology excluded malignancy. The patient underwent circumareolar incision and drainage under general anaesthesia with breakdown of loculations and wound packing. Ciprofloxacin was administered per the culture sensitivity results postoperatively. Delayed primary closure on day 7 resulted in complete resolution. Histopathology confirmed antibioma. Two features make this case unusual: the patient was a non-lactating woman with nipple retraction mimicking carcinoma, and the causative organism was MRSA and therefore resistant to both prescribed cephalosporin courses from the outset.