A 62-Year-Old Man With Tricuspid Valve Endocarditis, Bacteremia, and Septic Pulmonary Embolism Following Long-Needle Acupuncture.

This case report describes a serious complication that occurred in a 62-year-old man following long-needle acupuncture treatment. The patient had no underlying health conditions that would normally increase infection risk, yet he developed a severe bacterial infection just three days after receiving acupuncture. The infection was caused by methicillin-susceptible Staphylococcus aureus (MSSA), a common bacteria that can be dangerous when it enters the bloodstream.

What happened in this case was particularly concerning. The bacteria infected the patient's tricuspid valve (a heart valve on the right side), causing infective endocarditis—a serious heart infection. The infection also spread to his lungs, causing septic pulmonary embolism, and formed abscesses in multiple muscle groups and damaged vertebrae in his spine. The patient initially received standard antibiotic treatment with cefazolin, which seemed to work at first, but the infection returned on day 10 of hospitalization.

Treatment proved challenging because neither cefazolin alone nor daptomycin alone could fully control the infection. Doctors eventually used a combination approach, followed by six weeks of antibiotic therapy before the infection finally resolved. This case is particularly notable because right-sided heart valve infections from acupuncture are extremely rare and typically only occur in people with pre-existing risk factors like damaged heart valves or intravenous drug use.

For patients considering acupuncture, this case highlights the importance of sterile technique and proper needle handling. While such severe complications are rare, they demonstrate that acupuncture performed under poor sterilization conditions can lead to life-threatening infections even in otherwise healthy individuals. Always seek treatment from a properly licensed and qualified acupuncture practitioner who follows strict sterilization protocols.

This case report documents a rare presentation of acupuncture-associated right-sided infective endocarditis (RIE) in an immunocompetent 62-year-old male without traditional risk factors. Following long-needle acupuncture, the patient developed methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia progressing to tricuspid valve endocarditis with septic pulmonary embolism. The case is notable for demonstrating treatment challenges with persistent bacteremia despite initial cefazolin monotherapy, which failed by hospital day 10. Subsequent daptomycin monotherapy also proved inadequate due to poor pulmonary distribution. Clinical complications included disseminated abscesses in bilateral psoas, iliopsoas, and erector spinae muscles with L3/L4 vertebral destruction. Resolution ultimately required sequential combination therapy (cefazolin plus daptomycin for 5 days) followed by extended cefazolin monotherapy for 6 weeks. This represents one of the few documented cases of acupuncture-induced native valve RIE in non-IVDU patients, emphasizing the critical importance of proper sterilization technique and the complexity of treating MSSA RIE with persistent bacteremia when standard monotherapy approaches fail.