Acute Multifocal Osteomyelitis Following Acupuncture: A Case Report.

Abstract

Osteomyelitis was not listed as a complication of acupuncture in a recent review of one million self-reported treatments1 and has not been identified in limited safety data on acupuncture from randomized trials2. The aims of this case report are to highlight a rarely recognized instigator of acute osteomyelitis and stress the importance of a thorough history, physical examination, and radiographic evaluation in patients presenting with signs and symptoms of osteomyelitis following acupuncture. The authors obtained the patient’s informed consent for publication of this case report. A fifteen-year-old previously healthy adolescent male basketball player presented with right shoulder pain and a fever of four days’ duration. During a basketball game three weeks prior to presentation, the patient sustained a right shoulder “strain” for which he did not seek medical treatment. Because of continued discomfort with activity, he underwent acupuncture five days prior to presentation to us; ten separate needles were inserted into the skin overlying both shoulders and upper extremities. According to the acupuncturist, meridians of Chinese acupuncture postulated to alleviate shoulder pain were chosen as locations for needle insertion, including five separate areas overlying the clavicle, acromion, and scapula on both sides. The treatment areas were prepared with alcohol-based cleaning wipes prior to the insertion of disposable 2-in stainless-steel needles. Each needle remained in the skin for approximately thirty minutes. On awakening the following morning, the patient felt subjectively febrile and noticed a “stinging” quality to the right shoulder pain. The pain increased progressively and was not relieved with nonsteroidal anti-inflammatory medication. At initial presentation to us, the patient described sharp, nonradiating right shoulder pain, rated 8 of 10 and exacerbated erythrocytewith movement. There was also mild, nonspecific left shoulder pain. Examination was notable for a fever of 39.4°C and diffuse …