title: Delayed development of toxic shock syndrome following abdominal tissue expansion in a pediatric reconstruction patient: case report.
abstract: Toxic shock syndrome (TSS) is a potentially fatal postoperative complication, and even more so if the diagnosis is delayed. We present the case of a 7-month-old male infant who developed TSS as a complication of tissue expansion using an external port device. There have been 5 documented cases of TSS after tissue expander or breast prosthesis placement occurring in the adult population, however, there has not been a reported case of TSS in an infant. The long interval to development of TSS like symptoms, 4 months in this case, should not exclude TSS from the differential diagnosis. In a pediatric patient, a diffuse macular rash without the severe systemic symptoms on initial presentation can present as a diagnostic challenge. New diagnosis techniques are discussed that can shorten the time to a diagnosis of TSS. In this case, because the local bacterial count was low, the expanded tissue was transferred without complication.
authors.affiliation: Department of Surgery, The University of Oklahoma Health Sciences Center, 920 Stanton L Young Blvd., Oklahoma City, OK, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hromadka
authors.forename: Jordan
authors.initials: J
authors.lastname: Deschamps-Braly
authors.forename: Kamal
authors.initials: K
authors.lastname: Sawan
authors.forename: Christian
authors.initials: C
authors.lastname: El Amm
mesh_terms: D001132:Arm; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009506:Nevus / Q000151:congenital / Q000601:surgery*; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D012878:Skin Neoplasms / Q000151:congenital / Q000601:surgery*; D013203:Staphylococcal Infections / Q000175:diagnosis; D013997:Time Factors; D015626:Tissue Expansion / Q000009:adverse effects*