title: Iatrogenic Mycobacterium abscessus infection associated with acupuncture: clinical manifestations and its treatment.
abstract: 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.
authors.affiliation: Department of Dermatology and Internal Medicine, Korea University Medical Center, Seoul, South Korea.
authors.forename: Hwa Jung
authors.initials: HJ
authors.lastname: Ryu
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Kim
authors.forename: Chil Hwan
authors.initials: CH
authors.lastname: Oh
authors.forename: Hae Jun
authors.initials: HJ
authors.lastname: Song
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin; D017291:Clarithromycin