# Anterior Cervical Abscess Following Anterior Cervical Discectomy and Fusion Caused by Moraxella catarrhalis: A Case Report and Focused Literature Review

## TL;DR

A rare case of a post-surgery neck abscess caused by a respiratory bacteria is reported, emphasizing the importance of considering unusual pathogens in high-risk patients.

## Contribution

This case report is the first to document Moraxella catarrhalis as a cause of postoperative anterior cervical abscess following ACDF.

## Key findings

- Moraxella catarrhalis was identified as the causative agent in a postoperative cervical abscess.
- The patient recovered fully with surgical drainage and targeted antibiotic therapy.
- The case highlights the need to consider respiratory tract organisms in postoperative infections.

## Abstract

Background: Anterior cervical discectomy and fusion (ACDF) is widely performed and has a low incidence of postoperative infection. Anterior cervical abscess is a rare but potentially life-threatening complication, typically caused by skin or oral flora. Identification of atypical pathogens has important implications for diagnostic vigilance and antimicrobial management. Case Presentation: We report a 56-year-old man with degenerative cervical myelopathy and significant respiratory comorbidity who underwent single-level ACDF and developed progressive dysphagia and neck pain in the early postoperative period. Imaging demonstrated a prevertebral abscess requiring urgent surgical drainage. Intraoperative cultures identified Moraxella catarrhalis, a respiratory tract commensal rarely implicated in postoperative spinal infections. No evidence of esophageal perforation or superficial wound contamination was identified. The patient was treated with surgical washout and prolonged culture-directed antibiotic therapy, with full clinical recovery. To contextualize novelty, we performed a focused review of the available literature on M. catarrhalis spinal infections. Conclusions: This case expands the spectrum of pathogens implicated in postoperative cervical spine infections and highlights the need to consider respiratory tract organisms in high-risk patients, particularly those with chronic pulmonary disease or immunosuppression. Early imaging in the presence of dysphagia, prompt source control, and culture-directed antimicrobial therapy are essential to optimizing outcomes.