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成人因流感嗜血杆菌引起的颈椎硬膜外脓肿:一例报告

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

作者信息

Qiao Luxi, Choi April, Jung Julianna

机构信息

Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.

出版信息

Cureus. 2024 Dec 2;16(12):e74946. doi: 10.7759/cureus.74946. eCollection 2024 Dec.

Abstract

Pyogenic spinal infections due to  ()are rare. After a search of the literature, we deemed our case to be the first description of spinal epidural abscess (SEA) from . 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 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  and increase awareness of this atypical presentation of a rare yet invasive disease.

摘要

由()引起的化脓性脊柱感染很少见。在检索文献后,我们认为我们的病例是首例关于来自()的脊柱硬膜外脓肿(SEA)的描述。这是一名74岁的女性患者,有糖尿病史,两天前最初被诊断为病毒性鼻窦炎后,因发热和颈部持续疼痛就诊于急诊科。神经系统检查未发现缺陷。由于脑脊液细胞增多和CT影像学表现,她因可能的脑膜炎或肌肉内脓肿入院。然而,患者入院期间进行的MRI显示为多节段颈椎SEA,可能源于侵袭性()感染,患者接受了清创手术,预后良好。硬膜外脓肿很少单独出现在颈部区域,在初次就诊时甚至在诊断检查过程中,可能会被误诊为颈部疼痛的其他更常见的感染性和非感染性原因。然而,如果通过先进影像学诊断和手术治疗延迟,会有显著的发病率。我们旨在呈现首例来自()的SEA报告病例,并提高对这种罕见但侵袭性疾病非典型表现的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30a1/11688608/b84a7065b257/cureus-0016-00000074946-i01.jpg

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