Acute shoulder infection following acupuncture—A report of three cases

Worldwide, acupuncture is a popular alternative medicine for releasing pain, treating diseases, or promoting health. Although it is generally considered safe, a few complications have been reported. These complications ranged from minor side effects, such as pain, local hematoma formation, or the aggravation of symptoms, to serious complications including mechanical injuries, such as pneumothorax and severe infection requiring surgical treatment. In orthopedic clinics, reports of complications caused by acupuncture are rare. We present three cases who developed severe infection following acupuncture, leading to irreversible osteoarthritic changes in their glenohumeral joints. All of them mentioned a history of acupuncture therapy before their shoulder became swollen and hot and no other infection source could be detected. Possible explanations included: (1) breakdown of the sterile technique; (2) no consensus of acupoint or how deep the needle should be inserted; (3) patient’s comorbidities, such as diabetes mellitus or previous shoulder pathology, were not considered. Although these three patients underwent debridement and proper management with antibiotics according to the culture data, eventually, they still progressed to severe glenohumeral joint destruction. Strict infection control guidelines should be established to lower this type of life-threatening complication.