Finegoldia magna Infection in the Lumbar Intervertebral Disc Following Acupuncture with Cupping: A Rare Case Report.

BACKGROUND: Finegoldia magna is a common Gram-positive anaerobic coccus that forms part of the normal flora of the skin, oral cavity, and gastrointestinal tract. However, in certain clinical settings, such as disruption of the mucocutaneous barrier or immunosuppression, it can act as an opportunistic pathogen, accounting for approximately 5-12% of anaerobic infections, and may cause a variety of conditions, including skin and soft tissue infections, bone and joint infections, breast abscesses, and diabetic foot infections. Here, we present the first reported case of deep lumbar spine infection caused by Finegoldia magna due to improper acupuncture combined with cupping therapy.

CASE PRESENTATION: We report the case of a 58-year-old patient with lumbar disk herniation who developed F. magna infection of the lumbar disk following acupuncture with wet cupping therapy. Post-debridement treatment with piperacillin-tazobactam lowered C-reactive protein levels. However, during follow-up, the patient reported persistent pain, and C-reactive protein levels increased again. Changing the antibiotic regimen to oral amoxicillin-clavulanate potassium combined with moxifloxacin improved and stabilized the symptoms.

CONCLUSION: Our findings highlight the need for thorough cleaning and disinfection of tools and the patient's skin during acupuncture treatment. Moreover, as debridement of lumbar spine infections may yield false-positive results regarding antibiotic efficacy, we recommend at least 2 months of follow-up after debridement, as well as prompt adjustment of the antibiotic regimen based on patient symptoms to prevent infection recurrence.