Cervical Spinal Epidural Abscess From Haemophilus influenzae in an Adult: A Case Report

Pyogenic spinal infections due to Haemophilus influenzae (H. influenzae) are rare. After a search of the literature, we deemed our case to be the first description of spinal epidural abscess (SEA) from H. influenzae. This is a 74-year-old female patient with a history of diabetes who presented to the emergency department with fever and persistent paracervical pain after being initially diagnosed with viral sinusitis two days prior. The examination was negative for neurologic deficits. She was admitted for possible meningitis versus intramuscular abscess due to cerebrospinal fluid pleocytosis and CT imaging findings. However, an MRI obtained during the patient's admission revealed a multi-level cervical SEA, likely from an invasive H. influenzae infection, and the patient underwent evacuation surgery with a good outcome. Epidural abscesses are rarely present in isolation in the cervical region and can be mistaken for other more common infectious and non-infectious causes of neck pain on initial presentation and even as diagnostic work-up progresses. However, there is significant morbidity if diagnosis via advanced imaging and surgical treatment is delayed. We aim to present the first reported case of SEA from H. influenzae and increase awareness of this atypical presentation of a rare yet invasive disease.