title: A rare case of multiple spinal epidural abscesses and cauda equina syndrome presenting to the emergency department following acupuncture.
abstract: BACKGROUND
  Acupuncture is a form of traditional Chinese medicine being increasingly used as complementary therapy in many countries. It is relatively safe and rarely associated with deep infections.
  
  
  METHODS
  In this case report, we describe a middle-aged Chinese patient who presented acutely to our emergency department with cauda equina syndrome secondary to acupuncture-related epidural abscesses, which were treated with surgical decompression and intravenous antibiotics. We also present a review of case reports of this rare condition in available literature.
  
  
  CONCLUSIONS
  Emergency physicians should be aware that spinal abscesses may occur after acupuncture, with a broad spectrum of clinical presentations. If a history of recent acupuncture over the symptomatic area is elicited, a high index of suspicion should be maintained and appropriate imaging performed to establish the diagnosis. Treatment is directed by a number of factors, such as severity and duration of neurological deficit and progression of symptoms.
authors.affiliation: Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. cj.jing@gmail.com.
authors.forename: Jing Jing
authors.initials: JJ
authors.lastname: Chan
authors.affiliation: Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Oh
keywords: Acupuncture; Cauda equina syndrome; Spinal epidural abscess