Iatrogenic Mycobacterium abscessus infection associated with acupuncture: clinical manifestations and its treatment.
BACKGROUND
Mycobacterial infections transmitted by acupuncture are an emerging problem. There have been two reports of mycobacterial infections complicating acupuncture in the English literature.


OBJECTIVE
To describe the clinical manifestations and treatment of patients who acquired localized Mycobacterium abscessus infection in the process of acupuncture.


METHODS
Clinical manifestations and responses to different methods of treatment were reviewed in 40 patients who developed various skin lesions after acupuncture at a Korean oriental medicine clinic. Results The morphology of the lesions which developed at the acupuncture sites varied. Although the lesions disappeared with the combined administration of clarithromycin and amikacin for 3 months in most cases, five out of 25 patients (20%) showed residual lesions at the end of treatment, and had to be treated with a higher dosage of clarithromycin or alternative antibiotics based on sensitivity tests.


CONCLUSIONS
We recommend at least 3 months of treatment with clarithromycin for treating skin infections caused by M. abscessus, with supplementary antibiotics selected based on patients' drug sensitivity tests.
Ryu
Hwa Jung
HJ
Department of Dermatology and Internal Medicine, Korea University Medical Center, Seoul, South Korea.
Kim
Woo Joo
WJ
Oh
Chil Hwan
CH
Song
Hae Jun
HJ
D015670:Acupuncture Therapy / Q000009:adverse effects*; D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012867:Skin / Q000187:drug effects / Q000473:pathology; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000583:Amikacin; D017291:Clarithromycin