INAPPROPRIATE BREAST SECRETIONS OF POSSIBLE BACTERIAL ETIOLOGY IN THEPAROUS NONPUERPERAL FEMALE

This article presents two cases of spontaneous green breast secretions of parous nonpuerperal patients. To understand the nature of these se cretions, bacterial evaluations and subsequent treatment were undertak en. Case 1 culture and sensitivity studies from breast secretions were commenced within 24 hours yielding an isolate identified as Staphyloc occus epidermidis, with sensitivity to cephalothin, erythromycin, and tetracycline but resistant to penicillin. Cephalothin, 500 mg four tim es a day for 10 days, followed by erythromycin 100 mg twice a day for 10 days and doxycycline 100 mg twice a day for 10 days, did not alter the breast secretions. Four weeks later, ciprofloxacin HCl 500 mg twic e a day for 6 weeks caused a 50% decrement in breast secretion at 4 we eks but increased clinical depression. At 6 weeks, no evidence of brea st secretions persisted. Mental depression decreased within 2 weeks po stciprofloxacin treatment.In Case 2, a total of 35 minutes elapsed bet ween sample collection and initiation of culture and sensitivity studi es. Moraxella osloensis was identified and found sensitive to ampicill in and tetracycline but resistant to trimethoprim. Ampicillin 500 mg f our times a day for 10 days and doxycycline 100 mg twice a day by mout h for 10 days were administered at 2-week intervals with no effect on breast discharge. After 4 weeks of treatment failure, ciprofloxacin HC l 500 mg twice a day for 6 weeks caused a 50% decrease in discharge at 2 weeks and total elimination at 6 weeks. Lethargy during treatment c eased with termination of therapy. These results support the importanc e of bacterial evaluation of breast secretions with subsequent antibio tic therapy. Ciprofloxacin HCl provides suitable treatment for some sp ontaneous breast secretions.