Infected Breast Reconstruction Associated with Poland's Syndrome

摘要

A 21-year-old woman with left breast hypoplasia associated with Poland's syndrome underwent breast reconstructioncolon; removal of a previous implant, capsulotomy, and transverse myocutaneous island flap to the left chest. Eight weeks later, she returned with purulent drainage and cellulitis. Chest radiographs and radionuclide bone imaging demonstrated rib deformities of Poland's syndrome but no evidence of osteomyelitis. The bone scan also revealed abnormal soft tissue accumulation in the area of the reconstruction. Computerized tomography showed nonhomogeneous soft tissue density of the reconstruction compatible with fat and fibrous tissue. A gallium scan confirmed infection of the reconstruction. Debridement revealed extensive fat necrosis with cultures positive forStaphylococcus epidermidisandStreptococcus viridans. There was an excellent response to antibiotic therapy after debridement.