Granulomatous breast mastitis in pregnancy secondary to

Introduction: Granulomatous breast mastitis is a rare inflammatory condition that can mimic both infectious mastitis and breast malignancy. Its occurrence during pregnancy is uncommon and poses significant diagnostic and therapeutic challenges. Case presentation: A 42-year-old immunocompetent woman, gravida 7 para 6, presented at 4 weeks' gestation with progressive left breast pain, swelling, and erythema. Sequential antibiotic courses failed to produce sustained improvement, and the condition progressed to recurrent abscess formation requiring multiple aspirations and two formal incision-and-drainage procedures. An initial culture grew Clinical discussion: This case highlights the importance of maintaining a high index of suspicion for atypical mycobacterial pathogens in recurrent or treatment-resistant granulomatous mastitis. A comprehensive microbiological workup, including mycobacterial culture, is essential before initiating immunosuppressive therapy. The identification of MAC as the causative organism fundamentally altered the management strategy. Conclusion: Conservative management during pregnancy, followed by targeted postpartum antimycobacterial therapy, can achieve complete resolution in MAC-associated granulomatous mastitis, even in immunocompetent patients.