Teaching NeuroImages: Multiple epidural abscesses after acupuncture
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An 80-year-old woman presented with 2 days of progressive quadriparesis, difficulty voiding, and fever. She had received acupuncture in the cervical and lumbar regions for 5 days beginning a week before. Whole-spine MRI showed multiple epidural abscesses at levels C3-C7, L3-L5, and L5-S1 (figure). Broad-spectrum antibiotics were administered, and the abscesses were surgically drained. Strains of Staphylococcus aureus were isolated. Single epidural abscesses after acupuncture have been reported, but multiple abscesses due to acupuncture are extremely rare.1,2
There are also multiseptated abscesses (arrow) in the right paravertebral muscle from C3 to C7, the right scalenus anterior muscle at C7, and the left paraspinous process area from L3 to S1. An epidural abscess at the C6–C7 level induced compressive myelopathy (black arrowhead).
AUTHOR CONTRIBUTIONS
Hyun-Jeung Yu: writing the manuscript. Ku-Eun Lee, Hyun Seok Kang, Sook Young Roh: review and discussion of the manuscript.
STUDY FUNDING
No targeted funding reported.
DISCLOSURE
The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- © 2013 American Academy of Neurology
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