Infection, neck pain due to acupuncture treatment of herniated disc.

01/04/2021 09:14

In early 2021, the Department of Septic Surgery and Wound Care, Viet Duc University Hospital received a male patient (56 years old, from Hai Phong) who admitted with his of neck abscess. After investigating, the history of patient has the  disc herniation for many years, often suffers shoulder and nape pain, and had difficulty in neck movement. Fear of surgery, the patient and his family decided to choose oriental medicine: acupuncture treatment…

 

After numerous injections, this time the patient accidently had fever, neck pain worsens… immediately was taken to Viet Duc University Hospital with signs of infections, severe neck pain, swallowing manifestation. On MRI, doctors have identified 2 abscesses in front of spine and next to the left side of neck.  He was indicated for surgery to drain, remove abscesses. Microbiological study results as predicted previously is bacteria Staphylococcus Aureus. The surgical team is combined the surgeons and ENT doctor of the hospital. Immediately after surgery, the patient had less difficulty to breath, after 3 days he was able to eat and drink, and was stable and discharged after 7 days of surgery.

 

 

Dr. Pham Vu Hung MD. MS., Interim chief of the Department of Septic Surgery and Wound Care, Viet Duc University Hospital, who directly performance this surgery informed: Normally, the mediastinal abscesses was drained pus through the neck or thoracic once ruptured in the mediastinum or both of 2 ways. However, with this case, we have to combine drainage from the throat with the specialized EMT instruments. After surgery, the patient is treated with appropriate antibiotics, which can affect the Staphylococcus aureus, so the disease progresses well without any dangerous complications.

 

 

Assoc. Prof. Nguyen Duc Chinh MD. PhD., Former Head of Department of Septic Surgery and Wound Care, Viet Duc University Hospital shared: In fact, acupuncture as well as oriental medicine has been approved for long time and it is effective in many diseases. However, sterilization should be followed when performing the medical procedure. The isolated bacteria were evidence of infected instruments used. Furthermore, we also recommend that mediastinal abscess is a  serious and complex disease that should be detected and treated in a qualified medical centers.

 

Mediastinal abscess is a serious infectious disease of the connective tissues, so it is widespread, especially in cases where it spreads in thoracic area are more dangerous and there is a high risk of death due to rupture into the large blood vessels or complicate the pericardium and pleural effusion. Despite progress in treatment and resuscitation, death caused by mediastinal abscess is still high so far (nearly 60% in some reports). The patients died in the case of severe infection or acute bleeding.  

 

 

The causes of mediastinal abscess are original from pharyngeal infections such as oral and dental infections, esophageal perforation due to trauma by swallowing bones or spontaneous rupture of the esophagus in Boerhaave syndrome. However, there are common causes after medical intervention called the iatrogenic complication, caused by medical interventions, for example, esophageal perforation after esophagoscopy or cervical spinal implant surgery … The case above is also an example of complications after medical intervention and it is quite rare.

 

In cases of mediastinal abscess caused by direct damage to the pharynx, esophagus, Gram (+) bacteria are usually Streptococcus species, Enterococcus faecalis, Acinetobacter Baumanii; Gram (-) bacteria are usually Klebsiella pneumonie, Pseudomonas aeruginosa …, they exist endogenously in the cavities of the body, particular in mouth. However, in this case, the bacteria isolated is  Staphylococcus Aureu,s only available in the surface of body and penetrated inside through the needle caused the infection.