Yang Weihang, Xia Shuang, Li Liang, Xu Jiahao, Ji Hongjian, Yao Wanglin, Shi Fengchao
Department of Orthopedics, Affiliated Hospital 6 of Nantong University, The Third People's Hospital of Yancheng, Yancheng, Jiangsu, People's Republic of China.
Department of Pharmacy, Jiangsu Vocational College of Medicine, College of Pharmacy, Yancheng, Jiangsu, People's Republic of China.
Infect Drug Resist. 2024 Dec 25;17:5839-5846. doi: 10.2147/IDR.S500762. eCollection 2024.
This report describes a case of lumbar disc infection potentially induced by acupuncture in a 43-year-old male with a history of back pain. After acupuncture treatment at another hospital, the patient experienced worsened pain. Physical examination revealed tenderness at the upper lumbar intervertebral space and paravertebral percussion pain. Laboratory tests showed no bacterial growth in both aerobic and anaerobic blood cultures after 5 days, but C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly elevated. CT and MRI scans revealed osteolysis of the L2/3 vertebral body and a paraspinal abscess in the left psoas muscle. The patient was treated with intravenous vancomycin (1 g every 12 hours for 4 weeks). After two weeks, CRP normalized, but ESR remained elevated. By week three, CRP increased to 61.19 mg/L, and severe anemia developed. Follow-up MRI indicated worsening of the lumbar infection. A transfusion was performed, and surgery was conducted in the fourth week. Intraoperative findings confirmed methicillin-resistant Staphylococcus aureus (MRSA) as the causative pathogen. Postoperatively, symptoms improved, and inflammatory markers normalized. This case highlights the need for standardized acupuncture practices and prompt surgical intervention in cases of infectious discitis unresponsive to conservative treatment.
本报告描述了一例43岁有背痛病史男性因针灸可能诱发腰椎间盘感染的病例。在另一家医院接受针灸治疗后,患者疼痛加剧。体格检查发现上腰椎间隙有压痛,椎旁有叩击痛。实验室检查显示,5天后需氧和厌氧血培养均无细菌生长,但C反应蛋白(CRP)和红细胞沉降率(ESR)显著升高。CT和MRI扫描显示L2/3椎体骨质溶解,左侧腰大肌有椎旁脓肿。患者接受静脉注射万古霉素治疗(每12小时1 g,共4周)。两周后,CRP恢复正常,但ESR仍升高。到第三周时,CRP升至61.19 mg/L,并出现严重贫血。随访MRI显示腰椎感染恶化。进行了输血治疗,并在第四周进行了手术。术中发现证实耐甲氧西林金黄色葡萄球菌(MRSA)为致病病原体。术后症状改善,炎症指标恢复正常。该病例凸显了规范针灸操作的必要性,以及对保守治疗无反应的感染性椎间盘炎病例进行及时手术干预的必要性。