Bilateral pneumothorax following acupuncture

A 57-year-old female presented to our emergency department with dyspnoea and cough two hours after receiving acupuncture on both sides of her back for dizziness. Acupuncture was applied to 16 sites from the posterior neck to the back. The needles were 0.16 mm in diameter and 3 cm in length. On arrival, the patient was alert and oriented, with a respiratory rate of 28 breaths/min, heart rate of 90 bpm, blood pressure of 148/89 mmHg, and 92% peripheral oxygen saturation upon 5 L/min oxygen administration via a face mask in room air. Decreased breath sounds were noted bilaterally. Skin findings on the chest and back were normal. Computed tomography before drainage revealed bilateral pneumothorax with slight subcutaneous emphysema around the fifth and sixth ribs in the left chest (Fig. 1). Bilateral chest drains were inserted, which resulted in rapid improvement in respiratory status and good lung re-expansion. The drains were removed four days later, and the patient was discharged.