Necrotizing fasciitis after acupuncture in a patient with aplastic anemia

Objectives: The objective of this study was to describe a serious complication of acupuncture treatment in a high-risk patient with aplastic anemia. Design: A 44-year-old woman with aplastic anemia experienced right calf pain after running. After poor results with physical therapy, she received needle acupuncture for pain relief. However, aggravated pain with swelling of the right calf developed 2 days later. Results: On admission, she had a temperature of 38.8°C, a white blood cell count of 500/μL, and hemoglobin of 5.7g/dL. Ultrasound and computed tomography scans showed swelling of the right calf muscle fascia, and aspiration drew out Staphylococcus infection. The symptoms improved after treatment with parenteral antibiotics. Conclusions: This case illustrates that necrotizing fasciitis must be considered as a possible complication of acupuncture in high-risk patients, and that early recognition and treatment of this life-threatening soft-tissue infection must be emphasized. Extreme caution should be employed when using acupuncture for high-risk patients, such as those with aplastic anemia.