[A case of pyogenic vertebral osteomyelitis caused by Haemophilus aphrophilus]

On Aug. 3, 1999, a 73-year-old male was admitted to our hospital with the chief complaint of pain in the neck, high fever, and numbness in the arm. MRI of the cervix showed high intensity at the C3/C4 disc space. Laboratory data showed several signs of inflammation. Haemophilus aphrophilus was detected from the specimen of the disc space, and the diagnosis of pyogenic vertebral osteomyelitis caused by H. aphrophilus was made. After the identification of H. aphrophilus, antibiotic therapy with Cefotiam (2 g/day) was given but his vertebral collapsed. Surgical treatment consisted of curettage and anterior spinal body fusion using the iliac bone, was performed on his 23rd hospital day, successfully. The antibiotic therapy of Cefazolin (2 g/day) was continued for the first 3 days, followed by Cefotiam (2 g/day) and later Levofloxacin (300 mg/day). The patient was discharged on the 88th hospital day. The origin of infecting H. aphrophilus in this patient was not clear, but oral source was suspected. We reported the first case of pyogenic vertebral osteomyelitis caused by H. aphrophilus in Japan.