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Toxic Shock Syndrome Caused by Methicillin-resistant After Immediate Breast Reconstruction With Tissue Expander.

Plastic and reconstructive surgery. Global open 2026 Vol.14(1) p. e7147

Ayabe N, Komiya T, Nakamura I, Shimada K, Ojima Y, Asaoka M, Ishikawa T, Matsumura H

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Toxic shock syndrome (TSS) is a severe postoperative infection characterized by rapidly progressing systemic symptoms, although local findings are typically unremarkable.

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APA Ayabe N, Komiya T, et al. (2026). Toxic Shock Syndrome Caused by Methicillin-resistant After Immediate Breast Reconstruction With Tissue Expander.. Plastic and reconstructive surgery. Global open, 14(1), e7147. https://doi.org/10.1097/GOX.0000000000007147
MLA Ayabe N, et al.. "Toxic Shock Syndrome Caused by Methicillin-resistant After Immediate Breast Reconstruction With Tissue Expander.." Plastic and reconstructive surgery. Global open, vol. 14, no. 1, 2026, pp. e7147.
PMID 41602843

Abstract

Toxic shock syndrome (TSS) is a severe postoperative infection characterized by rapidly progressing systemic symptoms, although local findings are typically unremarkable. Therefore, understanding its pathogenesis and ensuring early diagnosis are critical. To date, only 5 cases of TSS caused by methicillin-resistant have been reported in the context of breast reconstruction. We report a case of total mastectomy for breast cancer where a tissue expander was used. On postoperative day 12, the patient had hypotension, high fever, decreased consciousness, renal dysfunction, and gastrointestinal symptoms, indicating significant systemic deterioration. However, local findings at the surgical site were minimal, demonstrating a marked discrepancy between systemic manifestations and local signs. The patient was diagnosed with methicillin-resistant -induced TSS, and the primary treatment strategy involved the complete removal of the capsule and the administration of intravenous antibiotics.