Disseminated infection caused by Mycobacterium sherrisii in an HIV-negative patient from China: A case report and literature review.

A recent case report from China describes a serious infection that developed in a 54-year-old woman following cervical acupuncture treatment. The patient underwent acupuncture on the right side of her neck and subsequently developed persistent swelling of lymph nodes with subcutaneous air pockets. She experienced systemic symptoms including extreme fatigue, recurring fevers, and widespread bone pain that initially led doctors to suspect cancer. Medical imaging revealed the infection had spread to multiple organs including lymph nodes, esophagus, lungs, heart, and bones. Laboratory testing identified the cause as Mycobacterium sherrisii, a rare bacterial species that typically causes skin and soft tissue infections. The bacteria were detected in lymph node and bone marrow samples, and cultures from pericardial fluid, sputum, and pleural fluid confirmed the diagnosis through genetic sequencing. The patient was not HIV-positive, making this an unusual case of disseminated infection. Acupuncture was identified as the likely entry point for the bacteria. Treatment required a full year of targeted antibiotic therapy based on susceptibility testing, after which the patient fully recovered with no recurrence. The authors reviewed 26 total published cases of M. sherrisii infection to better understand this rare pathogen. This case highlights that while acupuncture is generally safe, serious infections can occur when proper sterile techniques are not followed. The infection's nonspecific symptoms made diagnosis challenging, requiring advanced laboratory methods. When considering acupuncture treatment, patients should seek qualified, licensed practitioners who follow strict infection control and sterilization protocols.

This case report documents disseminated Mycobacterium sherrisii infection in an HIV-negative 54-year-old Chinese female following cervical acupuncture. The patient presented with constitutional symptoms, persistent cervical lymphadenopathy with subcutaneous emphysema post-acupuncture, and imaging evidence of multiorgan involvement (lymph nodes, esophagus, lung, heart, bone). Diagnosis was confirmed through acid-fast bacilli detection via fluorescent staining and definitive identification using hsp65 gene sequencing and whole-genome sequencing of isolates from pericardial effusion, sputum, and pleural fluid. Treatment consisted of individualized antimicrobial therapy guided by drug susceptibility testing for 12 months, resulting in complete recovery without recurrence. The study included a literature review of 26 cases total. Key clinical implications include recognition that acupuncture can serve as a portal of entry for atypical mycobacterial infections, even in immunocompetent hosts. Disseminated M. sherrisii presents diagnostic challenges due to nonspecific presentation mimicking malignancy. Successful management requires prolonged, susceptibility-guided therapy. This underscores the critical importance of strict aseptic technique and proper needle sterilization in acupuncture practice.