Eikenella corrodens cervical spinal epidural abscess induced by a fish bone

Area of Science:

• Neurology
• Infectious Diseases
• Spinal Surgery

Background:

• Cervical spinal epidural abscesses are uncommon, particularly those stemming from foreign body ingestion.
• Eikenella corrodens, a common oral flora, is an unusual pathogen in deep-seated spinal infections.

Observation:

• A 72-year-old male presented with chronic neck pain, progressive right-sided weakness, and neck stiffness.
• A two-month history of a retained fish bone in the pharynx was reported.
• Neurological deficits included right hemiparesis and left-sided hypesthesia.

Findings:

• Magnetic resonance imaging revealed a retropharyngeal abscess and cervical myelitis.
• Elevated inflammatory markers (ESR/CRP) and leukocytosis were noted.
• Surgical decompression and antibiotic treatment were initiated, with removal of a fish bone from the C3-C4 intervertebral disc space.
• Eikenella corrodens was identified as the causative organism from abscess cultures.

Implications:

• This case underscores the potential for retained foreign bodies, like fish bones, to cause severe spinal infections.
• Eikenella corrodens should be considered in the differential diagnosis of spinal epidural abscesses, especially in patients with predisposing factors.
• Prompt surgical intervention and targeted antibiotic therapy are crucial for favorable outcomes in such complex cases.