Saline breast implant fluid collection and reactive arthritis in a patient with streptococcal toxic shock syndrome

• Published in: Journal of clinical rheumatology Vol. 17; no. 2; p. 89
• Main Authors: Kohannim, Omid, Rubin, Zachary, Taylor, Mihaela
• Format: Journal Article
• Language: English
• Published: United States 01.03.2011
• Subjects: Anti-Infective Agents - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Reactive - drug therapy; Arthritis, Reactive - etiology; Arthritis, Reactive - microbiology; Breast Implants - adverse effects; Female; Humans; Methotrexate - therapeutic use; Middle Aged; Shock, Septic - complications; Shock, Septic - drug therapy; Sodium Chloride - adverse effects; Streptococcal Infections - complications; Streptococcal Infections - drug therapy; Sulfasalazine - therapeutic use; Treatment Outcome
• ISSN: 1536-7355
• DOI: 10.1097/RHU.0b013e31820edb9d

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.