Infected Breast Reconstruction Associated with Polandʼs Syndrome

A 21-year-old woman with left breast hypoplasia associated with Polandʼs syndrome underwent breast reconstructionremoval of a previous implant, capsulotomy, and transverse myocutaneous island flap to the left chest. Eight weeks later, she returned with purulent drainage and cellulitis. Chest radiographs and radionuclide bone imaging demonstrated rib deformities of Polandʼs syndrome but no evidence of osteomyelitis. The bone scan also revealed abnormal soft tissue accumulation in the area of the reconstruction. Computerized tomography showed nonhomogeneous soft tissue density of the reconstruction compatible with fat and fibrous tissue. A gallium scan confirmed infection of the reconstruction. Debridement revealed extensive fat necrosis with cultures positive for Staphylococcus epidermidis and Streptococcus viridans. There was an excellent response to antibiotic therapy after debridement.