First Reported Case of Methicillin-Resistant Staphylococcus aureus Vertebral Osteomyelitis with Multiple Spinal and Paraspinal Abscesses Associated with Acupuncture

Table 1

Infectious complications related to acupuncture (MSSA and MRSA).

	References	Gender/age	Reason for acupuncture	Joint(s)/area(s) involved	Causative organism	Site(s) of positive culture	Treatment/duration of the therapy	Outcome
1	Kirschenbaum and Rizzo (1997) [2]	M/76	Intermittent left sided shoulder pain-several months duration	Left shoulder joint with diffuse swelling & tenderness	MSSA	Thick purulent synovial fluid	Arthrotomy, surgical debridement, partial synovectomy, and irrigation and oxacillin for 6 weeks	Remission
2	Laing et al. (2002) [3]	F/45	For faster recovery from (Schatzker type II) tibial plateau fracture	Left knee	MSSA	Skin swabs and joint fluid aspirate	Arthroscopic washout and 7-week antibiotic therapy	Decreased range of knee motion (0–120 degrees)
3	Woo et al. (2003) [4]	—	Low back pain	Back midline	MSSA	Subcutaneous abscess	Surgical debridement and drainage and 5-week cloxacillin therapy	Remission
4	Daivajna et al. (2004) [5]	M/48	Chronic low back pain	L5/S1 facet joint and lower paraspinal region	MSSA	CT-guided biopsy and joint aspirate	Surgical debridement and 6-week antibiotic therapy	Full range of movement of lumbar spine
5	Chen et al. (2004) [6]	M/44	Chronic nuchal and subscapular pain	Mass lesion involving C6–T1 spine causing cord compression	MSSA	Pus obtained at surgery	Laminectomy from C6 through T1, drainage of multiple subdural abscess, and copious irrigation and 6-week course of oxacillin and rifampin	Mild residual left hand paresis
6	Seeley and Chambers (2006) [7]	M/31	Persistent right hip pain	Right obturator externus and adductor muscles	MSSA	Blood culture, thigh abscess aspirate	CT-guided abscess drainage and 5-week antibiotic therapy	Remission
7	Lee et al. (2008) [8]	M/79	Unknown	Abdominal aorta	MRSA	Aortic wall and atheroma	Emergent exploratory laparotomy, resection of the infected aorta, debridement, and axillary to bifemoral bypass and prolonged; antibiotic therapy	Remission
8	Woo et al. (2009) [9]	F/43	Knee pain	Left knee	MRSA	Synovial fluid/tissue	Arthrotomy, synovectomy, and 6-month antibiotic therapy	Remission
9	Present case	F/57	Chronic back pain	Lumbar spine, spinal and paraspinal muscles	MRSA	Blood culture, skin lesion culture, paraspinal abscess aspirate culture	CT-guided abscess drainage and 12-week intravenous Vancomycin therapy	Remission

M: male, F: female.