A Case of Multiple Abscesses with Methicillin-resistant Staphylococcus Aureus Bacteremia following Acupuncture

Abstract

The patient was a 78-year-old woman who was emergently transferred to our hospital because of high fever and exacerbated lower back pain. Blood tests revealed an elevated inflammatory response and coagulation abnormalities. Abdominal computed tomography (CT) revealed a piriformis abscess. After the examination, an interview with the patient revealed that she had undergone acupuncture treatment previously. She was hospitalized following the diagnosis of systemic inflammatory response syndrome and disseminated intravascular coagulation due to abscesses that required antimicrobial drug treatment and percutaneous drainage. Methicillin-sensitive Staphylococcus aureus (MSSA) was detected in the blood and abscess cultures.

On the sixth day of hospitalization, CT revealed new abscesses in the iliopsoas and erector spinae muscles, and percutaneous drainage was performed for the second time. The occurrence of pain and infection after acupuncture treatment coincided ; therefore, the possibility of multiple abscesses with MSSA bacteremia due to acupuncture was considered. After the second drainage procedure, the inflammatory response quickly declined without abscess exacerbation. Therefore, the patient was discharged on the 42nd day. MSSA is considered as the most common cause of abscesses following acupuncture, and infection occurs due to inadequate infection management, but there are very few case reports in literature. Herein, we report one such case of abscesses following acupuncture along with a literature review.