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Forum Name: Other infections

Question: 2 problems


 Baby-P1nk - Wed Dec 01, 2004 12:56 pm

:( 2 Problems

I'm 19 and I have this sharp pain in my left breast. Right where I have the pain is a lump the size of an acorn. My doctor said it wasn't nothing, but the pain is getting more frequent and worse. What could it be? I've also have blood come out of my right nipple. Everyday, some yellowish liquid comes out of my right nipple too.

I've also have a series of a strange smell in my vagina. It leaves a yellowish mucus and it has a fishy smell, but no itching or burning. My doctor said it was vaginitis, but my vagina isn't swollen. How do I get rid of it? I took some medicine the doctor gave me. It got rid of the smell for a week, but it came back. :?:
 Dr. Anthony Solomon - Sun Dec 12, 2004 9:34 am

Hi,

First, let us look into the complaints you have about the left and right breasts:

i) a bloody and purulent (yellowish) discharge from the nipple of your RIGHT breast
ii) a sharp pain in the LEFT breast which is associated with a lump the size of an acorn. The pain is getting worse and more frequent. There is no nipple discharge.

You do not state if you are lactating, if you are on contraceptive pills and if the yellowish/bloody discharge is spontaneous or expressible. “Spontaneous” means that the discharge comes out on its own, without trying to force it out by manual expression. “Expressible” means that you have to manually express the discharge if it is to be visible.

You have consulted your doctor and it was dismissed as “nothing”.
Is that the doctor’s word or your own interpretation? The symptoms you are experiencing in both breasts warrant a specialist examination by a breast surgeon. I am personally surprised that you have not been referred to one.

In the non-lactating breast, the commonest causes of nipple discharge (in decreasing frequency) are duct ectasia, intraductal papilloma and malignancy.

Spontaneous, bloody discharge from a nipple is suggestive of a benign papilloma in the duct or a malignant lesion. At your age, it is more likely the former (women over 50 are more likely to have a malignant cause).
Purulent discharge from a nipple may be caused by a sub-areolar abscess.
Milky discharge in the non-lactating female occurs in certain endocrine disorders
A painful lump in the left breast may have several causes.

At your age, I am presuming that the causes of your breast lesions are benign, but further examination and investigations are mandatory to confirm the diagnosis. Please ask your doctor to refer you to the appropriate specialist.

In respect of your final complaint, a vaginal discharge that has a fishy odour and causes no vulvar itching or burning is very suggestive of Bacterial Vaginosis (BV). However, the discharge in BV is usually off-white or greyish-white in colour, not yellow. Was a sample of the vaginal fluid subjected to tests? The tests that could have been done at the time of your visit are simple and diagnostic: acidity (pH) test of the vaginal fluid; amine test (development of a fishy odour after mixing a sample of vaginal fluid with a particular chemical); and a sample to identify “clue cells” by microscopic analysis.
Bacterial Vaginosis does not cause an inflammation in the vagina, so you would not expect any swelling there.

What medicine was prescribed?

Thank you for contacting our website.

Dr Anthony Solomon
MB BS DTM&H DIP.VEN FRSM
Consultant Physician, Tropical & Genitourinary Medicine

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