Non-lactational Breast Abscess due to Burkholderia Contaminans – Case Report of a Rare Organism with Rare Presentation

Abstract Introduction: A breast abscess (BA) is a localized collection of purulent materials within breast tissues. BA are most frequently present during the lactational period, but they can rarely manifest in the non-lactational period. Staphylococcus aureus is the most common causative organism, mostly methicillin-resistant S. aureus, followed by coagulase-negative Staphylococci. Burkholderia contaminans is an uncommon opportunistic infection commonly associated with cystic fibrosis. BA due to a Burkholderia contaminans infection has never been reported previously. Case Presentation: We are reporting a 25-year-old immunocompetent woman with a non-lactational left BA caused by Burkholderia contaminans. She complaints of gradually progressive lump in her left breast for one year. Local examination revealed a tender swelling with induration and soft central region in the lower inner and outer quadrant suggestive of BA with palpable left axillary lymph node. She was successfully treated with ultrasound-guided needle aspiration followed by a course of culture-based antibiotics. Conclusions: Burkholderia contaminans is one of the 24 species in the Burkholderia cepacia complex (Bcc). Burkholderia contaminans is an extremely rare opportunistic pathogen with low virulence but extensive virulence factors. Bcc infection can vary from an asymptomatic carrier, chronic infection ranging from pulmonary involvement to invasive Bcc, and life-threatening presentation like cepacia syndrome, especially in CF and chronic granulomatous disease patients. In our patient symptoms of BA was chronic with recent aggravation. BA should be managed by incision and drainage or image guided needle aspiration, undercover of enteral or parenteral antibiotics depending upon severity of the disease.