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April 09, 2013; 80 (15) Resident and Fellow Section

Teaching NeuroImages: Multiple epidural abscesses after acupuncture

Hyun-Jeung Yu, Ku-Eun Lee, Hyun Seok Kang, Sook Young Roh
First published April 8, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31828c2f1d
Hyun-Jeung Yu
From the Bundang Jesaeng General Hospital, Gyeonggi Province, Korea.
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Ku-Eun Lee
From the Bundang Jesaeng General Hospital, Gyeonggi Province, Korea.
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Hyun Seok Kang
From the Bundang Jesaeng General Hospital, Gyeonggi Province, Korea.
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Sook Young Roh
From the Bundang Jesaeng General Hospital, Gyeonggi Province, Korea.
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Teaching NeuroImages: Multiple epidural abscesses after acupuncture
Hyun-Jeung Yu, Ku-Eun Lee, Hyun Seok Kang, Sook Young Roh
Neurology Apr 2013, 80 (15) e169; DOI: 10.1212/WNL.0b013e31828c2f1d

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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

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Figure Multiple epidural abscesses (arrowheads) at the levels of C6 to C7 and L3 to L5

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

REFERENCES

  1. 1.↵
    1. Bang MS,
    2. Lim SH
    . Paraplegia caused by spinal infection after acupuncture. Spinal Cord 2006;44:258–259.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Yazawa S,
    2. Ohi T,
    3. Sugimoto S,
    4. Satoh S,
    5. Matsukura S
    . Cervical spinal epidural abscess following acupuncture: successful treatment with antibiotics. Intern Med 1998;37:161–165.
    OpenUrlPubMed
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