Abstract
Here, we report a patient who developed toxic shock syndrome following an operation for breast cancer and who survived due to intensive care. The patient was a 48-year-old woman. We performed both mastectomy for left breast cancer after preoperative chemotherapy and dissection of the axillary lymph node. She developed a hematoma after the operation, but the bleeding was stopped by astriction leaving hematoma to remain under flap. We removed the drain tube on the 22nd postoperative day, and the patient was discharged from the hospital on the same day. The patient experienced fever, vomiting, and diarrhea on the evening she was discharged, and she was urgently re-hospitalized on the 24th postoperative day. Soft tissue-shadow covering from the left precordia to the flank and air patterns under the flap were observed on thoracoabdominal computed tomography. Upon opening the wound, we observed extensive muscular necrosis, and the patient was diagnosed with necrotizing fasciitis. Since the patient went into shock after re-hospitalization, we implemented intensive medical care with local negative pressure wound therapy against the wound. Methicillin-resistant Staphylococcus aureus (ET-C and TSST-1 producing bacterium) was detected in the bacterial culture obtained from the wound. The general condition of the patient improved owing to intensive care, which allowed resuturing of the wound using local negative pressure wound therapy under local anesthesia.
