Bilateral Iatrogenic Pneumothorax After Acupuncture in a 26-Year-Old Woman Presenting With Cough, Pleuritic Chest Pain, and Tachycardia: A Case Report.
Jakub Nożewski, Bernadeta Zalewska, Beata Zwierko
✦ AI-curated · Sources linked
Case in brief
A 26-year-old woman presented two days after trapezius-region acupuncture with persistent cough, pleuritic chest pain, and difficulty taking a full breath; she had coughed during the needling. Despite oxygen saturation of 100% on room air and stable blood pressure, she was markedly tachycardic, with reduced right-sided breath sounds. Radiography and CT pulmonary angiography showed bilateral apical pneumothoraces, without hemothorax; pulmonary embolism was excluded. Given preserved oxygenation and no respiratory compromise, she received specialist-supervised inpatient conservative management without pleural intervention. Serial radiographs showed regression of both pneumothoraces before discharge.
What made this case unusual
Bilateral pneumothoraces followed upper-back acupuncture, yet oxygenation remained normal and the patient was hemodynamically stable. The case also describes regression with closely monitored conservative inpatient management, without pleural intervention.
Diagnostic / clinical pearl
After acupuncture involving the neck, shoulder, or upper back, consider pneumothorax when cough, chest pain, dyspnea, or unexplained tachycardia occurs—even with normal oxygen saturation.
Why it matters
Bilateral procedure-related pneumothorax may be managed conservatively in carefully selected patients, but this case supports doing so only with specialist oversight and close clinical and radiographic monitoring.