Elemental Dear Watson: Easy Clinical Reasoning

Clinical Summary

A 72-years-old woman was diagnosed with left breast cancer treated with neoadjuvant chemotherapy and mastectomy. Three months after the mastectomy, she presented heat and pain in the surgery area, presenting subcutaneous fluid that required periodic extractions.

 Clinical evolution

The patient returned to the hospital because of fever, chills and erythema throughout the area around the mastectomy, with pain on palpation. No data on pulmonary infection or urinary tract infection were observed.

The hemoglobin value was 7.8 g / dl, when ten days before was of 13 g / dl. A blood culture was performed that was positive for Streptococcus agalactiae. Antibiotic treatment was started, but erythema and pain did not improve. We show here the CT scan of the patient:

Image with patient inform consent


With the information provided, how do you think will be the aspect of the fluid?


2. Red



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