title: Saline breast implant fluid collection and reactive arthritis in a patient with streptococcal toxic shock syndrome.
abstract: Streptococcal toxic shock syndrome is a potentially lethal condition with an increasing incidence over the last 30 years. We present the case of a 55-year-old patient with signs and symptoms of streptococcal toxic shock syndrome. This patient's presentation was unique in that it was followed by an accumulation of fluid at her breast implant in addition to a polyarticular reactive arthritis. We propose that the patient's reactive arthritis is consistent with the diagnosis of post-streptococcal reactive arthritis, a variant of acute rheumatic fever, which similarly to its variant is immunologically driven. We hypothesize that the fluid collection around the patient's breast implant was triggered by her infection and was also immunologically mediated.
authors.affiliation: David Geffen School of Medicine, Los Angeles, CA, USA.
authors.forename: Omid
authors.initials: O
authors.lastname: Kohannim
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rubin
authors.forename: Mihaela
authors.initials: M
authors.lastname: Taylor
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012772:Shock, Septic / Q000150:complications* / Q000188:drug therapy; D012965:Sodium Chloride / Q000009:adverse effects*; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D018501:Antirheumatic Agents; D012460:Sulfasalazine; D012965:Sodium Chloride; D008727:Methotrexate