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Multifocal abscess formation and diffuse myositis of right paraspinal muscle at the level of L3, L4, L5 in magnetic resonance image. (A) axial view and (B) sagittal view at L3 level.
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Acupuncture has been widely used in alternative medicine for pain relief but may have many complications due to lack of appropriate cares. Pharmacopuncture is a sort of acupuncture that injects a herbal ingredient through a thin tube for the purpose of combining the effects of the herb and acupuncture and it has many pitfalls. The agents used in ph...
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... Pharmacopuncture is a new acupuncture therapy in which purified herbal medicine or pharmacological medication is injected into acupoints 17 . Pharmacopuncture may trigger more complications than casual acupuncture because complications can be related to the acupuncture process or the herbal medicine 18 . Moxibustion or cupping therapy also can injure the cutaneous structures, but these procedures seldom injure the subcutaneous adipose tissue or deeper structures. ...
Objectives: Drug fever and procedure-related fever are the causes of nosocomial fever. Oriental medicine has been practiced in Asia and is now being practiced as an alternative medicine in western countries. No data are available on the incidence of drug fever and procedure-related fever in oriental medical hospitals (OMHs). The aim of this study was to identify the incidence of drug fever related to oriental herbal medicine and oriental medical procedure-related fever.Methods: This was a retrospective study at one OMH of a university medical institute in Seoul, Korea, conducted from June 2006 to June 2013.Results: Overall, 95 episodes of drug fever occurred among 10880 patients treated with herbal medicine (0.89%). Peak body temperature was 38.37±0.58 ℃, and the fever lasted for 1.0 day (range 1.0-17.0 days). Eosinophilia was found in 15 patients (15.79%) and 8 patients developed toxic hepatitis (8.42%). Five patients had a drug-related skin rash (5.26%). The most common ingredients of the herbal medicines associated with drug fever were licorice, Angelica gigas root, and white Atractylodes rhizome. In total, 16 episodes of procedure-related fever (0.20%) occurred in 8125 patients treated with oriental medical procedures. The peak body temperature was 38.26±0.51 ℃, and the fever lasted for 1.0 day (range 1.0-3.0 days). Among various oriental medical procedures, moxibustion was the most common procedure related to fever, followed by acupuncture.Conclusions: The incidence of drug fever and procedure-related fever in oriental medicine is not high compared with the incidence in western medicine.
... Although acupuncture for lower back pain or neck pain that is performed by physicians was found to be a low-risk intervention in a large prospective study conducted in Germany, 38 certain case studies have reported infectious events or neurological complications after acupuncture treatments. 39,40 A large, well-conducted observational study aiming to provide safety data on the use of acupuncture for LSS, with highquality reporting on harm observed during clinical studies, is required to generate reliable evidence for the safety of acupuncture for this condition. 41,42 The possible acupuncture mechanisms used for LSS might be of interest. ...
Lumbar spinal stenosis (LSS) negatively affects patients' quality of life. No systematic review evaluating the effects and safety of acupuncture for this population is available. We aimed to evaluate evidence indicating the effectiveness and safety of acupuncture for LSS.
We searched five English-language databases (EMBASE, MEDLINE, CENTRAL, CINAHL, and AMED) and one Chinese database (CAJ) for randomised controlled trials (RCTs) and non-randomised controlled clinical trials (CCTs) of needle acupuncture for LSS. CCTs were analyzed only in terms of safety and intervention-related information.
Six RCTs (n=582) and six CCTs, which were all from China and reported in Chinese, were included. High or uncertain risk of bias and clinical heterogeneity due to different acupuncture techniques were observed. All RCTs compared different combinations or techniques of acupuncture. None of the included studies mentioned safety issues. Acupuncture combined with other interventions and/or with additional stimulation increased the number of improved patients compared with acupuncture alone or relatively simpler stimulation (n=582; relative risk, 1.16; 95% confidence interval 1.08-1.25). Pain intensity, overall symptoms, and functional outcomes related to LSS and quality of life showed significantly favourable improvement in the treatment group compared with the control group, which lasted for up to 6 months post-treatment.
We found no conclusive evidence of the effectiveness and safety of acupuncture for LSS because of high or uncertain risk of bias and the limited generalisability of the included studies. Future trials using rigorous methodology, appropriate comparisons and clinically relevant outcomes should be conducted.
... The search terms were "pharmacopuncture," "acupoint injection," "herbal acupuncture," "aqua acupuncture," "acupuncture point injection," and "point injection" (see Figs. 3,4). Fourteen referenced publications with the term "pharmacopuncture" in the title [1][2][3][4][5][6][7][8][9][10][11][12][13][14] are described in detail and cited in the list of references. Compared to acupuncture in general and electroacupuncture (see Fig. 3), this number of publications is very small; however, it is in the range of the number of publications of laser acupuncture. ...
... Pharmacopuncture(PP) materials bee venom PP meridian-field PP single-compound eight-principle PP literature available in Europe. However, there are reports about side effects [9] when the pharmacopuncture material is not produced under sterile conditions. The case report by Koo et al. describes multiple abscesses in the psoas region with fever and pain after pharmacopuncture [9]. ...
... However, there are reports about side effects [9] when the pharmacopuncture material is not produced under sterile conditions. The case report by Koo et al. describes multiple abscesses in the psoas region with fever and pain after pharmacopuncture [9]. Another systematic review and meta-analysis article was published recently in the renowned journal Evidence-based Complementary and Alternative Medicine [10]. ...
Pharmacopuncture, a new therapy in traditional medicine, has attracted significant attention since its introduction to the Western world. This short review article employs a database analysis to examine the profile of publication activity related to pharmacopuncture.
Three databases were searched: PubMed, Embase, and Cochrane. About 300 papers related to the topic "pharmacopuncture" were found in these three most-commonly-used databases.
Fourteen papers are described in detail and are discussed in the context of the research performed at the Medical University of Graz, especially by the Frank Bahr Research Group "Auriculomedicine and Pharmacopuncture."
High-tech research methods concerning future pharmacopuncture studies are briefly discussed.
... Chen et al., 1997;Matsumura et al., 1998;Yazawa et al., 1998;Lau et al., 1998;Ha et al., 1999;Origuchi et al., 2000;Ishibe et al., 2001;Nambiar & Ratnatunga, 2001;Laing et al., 2002;Uchino et al., 2002;S.Y. Lee & Chee, 2002;Shah et al., 2002;Woo et al., 2003;Y.P. Cho et al., 2003;Lin & Choong, 2003;Kettaneh et al., 2003;Daivajna et al., 2004;Saw et al., 2004;M.H. Chen & Huang, 2004;Studd & Steward, 2004;Vucicevic et al., 2005;Bang & Lim, 2006;Simmons, 2006;Seeley & Chambers, 2006;S. Lee et al., 2008;Tien et al., 2008;Richter et al., 2008;Morgan, 2008;Wu et al., 2009;Woo et al., 2009;Ogasawara et al., 2009;Nakajima et al., 2010;J.W. Kim & Y.S. Kim, 2010;Macuha et al., 2010;Koo et al., 2010;Chung et al., 2011) (Figure). Thirty-one (60%) of the cases were reported in the recent 10 years, which is probably related to the increase awareness of this disease entity and reporting of cases. ...
... Among the 52 sporadic cases, 37 (71%) patients had musculoskeletal and/or skin infections usually in the form of abscesses or septic arthritis, corresponding to the site of insertion of the acupuncture needles. One case involved use of pharmacopuncture (injection of herbal ingredient which was not produced by sterile standard processes through a thin tube for the purpose of combining effect of acupuncture and the herb) and resulted in multiple abscesses in the psoas region (Koo et al., 2010). In spite of the relatively short incubation period for pyogenic infection associated with acupuncture, the implantation of permanent needles could result in infection occurring years after acupuncture. ...
Are underdiagnosed, so clinicians should have a high index of suspicion
The patient was a 78-year-old woman who was emergently transferred to our hospital because of high fever and exacerbated lower back pain. Blood tests revealed an elevated inflammatory response and coagulation abnormalities. Abdominal computed tomography (CT) revealed a piriformis abscess. After the examination, an interview with the patient revealed that she had undergone acupuncture treatment previously. She was hospitalized following the diagnosis of systemic inflammatory response syndrome and disseminated intravascular coagulation due to abscesses that required antimicrobial drug treatment and percutaneous drainage. Methicillin-sensitive Staphylococcus aureus (MSSA) was detected in the blood and abscess cultures.
On the sixth day of hospitalization, CT revealed new abscesses in the iliopsoas and erector spinae muscles, and percutaneous drainage was performed for the second time. The occurrence of pain and infection after acupuncture treatment coincided ; therefore, the possibility of multiple abscesses with MSSA bacteremia due to acupuncture was considered. After the second drainage procedure, the inflammatory response quickly declined without abscess exacerbation. Therefore, the patient was discharged on the 42nd day. MSSA is considered as the most common cause of abscesses following acupuncture, and infection occurs due to inadequate infection management, but there are very few case reports in literature. Herein, we report one such case of abscesses following acupuncture along with a literature review.
