Staphylococcus aureus subcutaneous abscess complicating acupuncture: need for implementation of proper infection control guidelines.
We report a case of Staphylococcus aureus subcutaneous abscess centered over the Jizhong acupuncture point (DU 6) which lies along the Du (Back midline) meridian after acupuncture at the corresponding acupuncture point for low back pain. The patient recovered after surgical debridement and drainage and 5 weeks of cloxacillin therapy. Among the 16 anecdotal case reports of pyogenic bacterial infections complicating acupuncture described in the English literature (MEDLINE Search 1996-2002), S. aureus was documented to be the causative agent in 9 (56%). Three patients had septic arthritis, 2 had chronic osteomyelitis, 2 had abscess formation, 1 had chondritis, and 1 had infective endocarditis. Five patients had S. aureus bacteremia. All patients who recovered required prolonged antibiotic treatment of 5-6 weeks, and 6 required drainage and/or debridement. Overall, 3 patients (30%) died. S. aureus causes significant morbidity and mortality in patients who receive acupuncture treatment. More resources should be spent on implementation of proper infection control guidelines, as the money lost due to prolonged hospitalization and medication would far exceed that used for implementation.
Woo
P C Y
PC
Department of Microbiology, The University of Hong Kong, Queen Mary Hospital.
Lau
S K P
SK
Wong
S S Y
SS
Yuen
K Y
KY
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology*; D015670:Acupuncture Therapy / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017053:Infection Control / Q000592:standards; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012871:Skin Diseases / Q000175:diagnosis / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D040521:Subcutaneous Tissue