Frontiers in endocrinology · 2026
Case Report: Moxibustion-induced burns leading to disseminated methicillin-resistant Staphylococcus aureus infection in a patient with type 2 diabetes mellitus.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Liang Hong, Mao Zhen-Fang, Huang Jin-Yu, Yang Yang, Li Xue-Mei, Mao Jie-Feng, Li Qi, Zhang Yun-Bo, Wei Wu-Xiao
Аннотация
PURPOSE: To assess methicillin-resistant Staphylococcus aureus (MRSA) bloodstream dissemination risk from moxibustion burns in type 2 diabetes and raise awareness of iatrogenic skin injuries in high-risk populations.
BACKGROUND: Staphylococcus aureus (S. aureus) causes bloodstream and metastatic infections, with a mortality rate up to 30%. In diabetic patients, minor skin injuries can lead to fatal systemic infections due to immune dysfunction and neuropathy. Moxibustion is widely used for chronic pain, but its thermal safety in high-risk groups is under-evaluated. Multiorgan MRSA dissemination involving the vertebrae, epidural space, chest wall, liver, lungs, and lymph nodes is extremely rare and challenging.
CASE PRESENTATION: We report the case of a 61-year-old male patient with type 2 diabetes mellitus and peripheral neuropathy. He developed second-degree burns with bleeding on the lower back following moxibustion therapy for back pain. The initial symptom was fever, followed by progressive bilateral lower limb weakness, urinary retention, and acute neurological deterioration. Laboratory tests revealed significantly elevated white blood cell count and inflammatory markers. Blood and wound cultures were both positive for MRSA. Thoracic spine MRI showed T8-T9 vertebral osteomyelitis and an epidural abscess with spinal cord compression. PET-CT further revealed a right chest wall abscess, a micro-abscess in liver segment S2, right upper lobe pneumonia, and mediastinal and hilar lymph node involvement. The patient was diagnosed with MRSA bloodstream dissemination secondary to moxibustion-induced burns. He received vancomycin for 6 weeks and local debridement but refused surgical drainage due to financial constraints. Although the infection was controlled, paraplegia and urinary retention persisted. The patient remains under follow-up.
CONCLUSION: This case highlights that even minor burns caused by moxibustion in poorly controlled diabetic patients can serve as an occult portal for MRSA dissemination. Therefore, it is essential to routinely screen for peripheral neuropathy in diabetic patients before heat therapy and to perform strict skin monitoring afterward. For diabetic patients presenting with unexplained fever and neurological deficits, early blood and wound cultures as well as comprehensive imaging should be performed. Safety protocols for the application of traditional heat therapies in high-risk populations are urgently needed to address the current clinical safety gap.
BACKGROUND: Staphylococcus aureus (S. aureus) causes bloodstream and metastatic infections, with a mortality rate up to 30%. In diabetic patients, minor skin injuries can lead to fatal systemic infections due to immune dysfunction and neuropathy. Moxibustion is widely used for chronic pain, but its thermal safety in high-risk groups is under-evaluated. Multiorgan MRSA dissemination involving the vertebrae, epidural space, chest wall, liver, lungs, and lymph nodes is extremely rare and challenging.
CASE PRESENTATION: We report the case of a 61-year-old male patient with type 2 diabetes mellitus and peripheral neuropathy. He developed second-degree burns with bleeding on the lower back following moxibustion therapy for back pain. The initial symptom was fever, followed by progressive bilateral lower limb weakness, urinary retention, and acute neurological deterioration. Laboratory tests revealed significantly elevated white blood cell count and inflammatory markers. Blood and wound cultures were both positive for MRSA. Thoracic spine MRI showed T8-T9 vertebral osteomyelitis and an epidural abscess with spinal cord compression. PET-CT further revealed a right chest wall abscess, a micro-abscess in liver segment S2, right upper lobe pneumonia, and mediastinal and hilar lymph node involvement. The patient was diagnosed with MRSA bloodstream dissemination secondary to moxibustion-induced burns. He received vancomycin for 6 weeks and local debridement but refused surgical drainage due to financial constraints. Although the infection was controlled, paraplegia and urinary retention persisted. The patient remains under follow-up.
CONCLUSION: This case highlights that even minor burns caused by moxibustion in poorly controlled diabetic patients can serve as an occult portal for MRSA dissemination. Therefore, it is essential to routinely screen for peripheral neuropathy in diabetic patients before heat therapy and to perform strict skin monitoring afterward. For diabetic patients presenting with unexplained fever and neurological deficits, early blood and wound cultures as well as comprehensive imaging should be performed. Safety protocols for the application of traditional heat therapies in high-risk populations are urgently needed to address the current clinical safety gap.