Subclinical mastitis presenting as acute, unexplained, excessive crying inan afebrile 31-day-old female

We present a case of a 31-day-old female who presented with an acute, unexp lained, episode of excessive crying. The patient had no history of fever an d no fever on presentation. There was no evidence of skin erythema or swell ing on presentation. Chest radiograph and computed tomography of the head w ere normal. Urinalysis and cerebral spinal fluid analysis were normal. The white blood cell count was within normal limits (17,400 cells/mm(3)), It wa s not until 6 hours after the onset of inconsolable crying (2.5 hours after presentation to the emergency department) that the patient's temperature r ose to 38.5 degreesC (101.3 degreesF). Clinical signs of mastitis did not b ecome appreciable until the 2nd hospital day. We review the literature on i nfantile mastitis and acute, unexplained, excessive crying. The importance of a thorough, conservative approach to the infant with acute, unexplained, excessive crying is discussed.