A Case of Lumbar Spinal Epidural Abscess and Facet Joint Septic Arthritis Caused by Haemophilus influenzae in an Immunocompetent Host

Background: Haemophilus influenzae rarely causes spinal epidural abscess or septic arthritis of the facet joints. We report a case of lumbar spinal epidural abscess and facet joint septic arthritis caused by H. influenzae in an immunocompetent host. Methods: A 53-year-old female patient with lumbar spine disc herniation presented with lower back pain 5 days before admission. Results: The patient was diagnosed with an epidural abscess at the right posterolateral aspect of the lumbar spine at the L4-5 level, as well as facet joint septic arthritis at the right L4-L5 and L5-S1 levels. The patient had no neurological deficit. On the 2nd day of hospitalization, the patient underwent decompressive laminotomy and posterior instrumentation. H. influenzae was identified in the blood cultures. She was prescribed intravenous ceftriaxone for 11 days until discharge and levofloxacin for 76 days after discharge. The patient recovered without neurological sequelae. Conclusions: This case represents the first report of septic arthritis of the facet joint and indicates that H. influenzae is a rare pathogen of spinal infection but can lead to a spinal epidural abscess, irrespective of the host’s immune status.