A case of mycobacterium fortuitum infection at the site of acupuncture

Mycobacterial infections that are transmitted by acupuncture are an emerging problem. M. fortuitum is one of the rapid-growing atypical mycobacteria and this infection usually follows a puncture wound or a surgical procedure. We report here on a case of M. fortuitum infection following an acupuncture procedure. A 37-year-old woman presented with indurations and ulcerations of both popliteal fossae after undergoing acupuncture. The skin biopsy specimen showed suppurative inflammation with a lymphocytic infiltration, and the Ziehl-Neelsen stain for AFB was negative. Bacterial culture of the tissue fluid was negative. The culture of the tissue specimen and polymerase chain reaction revealed M. fortuitum. The infection responded to 10 weeks of treatment with isoniazid, rifampin and ethambutol, and four months of treatment with rifampin. Despite of the increasing popularity of acupuncture, the importance of infection control has not been adequately emphasized in oriental medicine. Education for proper infection control, including aseptic practice, is necessary for oriental medical doctors and practitioners.