Spinal Infection with Rare Cervical Epidural Air Bubbles

Spinal infections involving gas-forming pathogens are exceedingly rare, particularly in the cervical spine. We report the case of a 63-year-old male with a history of hypopharyngeal cancer who presented with neck pain and right upper limb weakness. Imaging studies revealed cervical epidural air bubbles and spinal cord edema at C1–C3. Laboratory findings were indicative of infection, and Streptococcus was identified through blood cultures. Urgent surgical decompression via laminectomy was performed, followed by antibiotic treatment. This case highlights the critical role of multimodal imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), in diagnosing spinal infections, especially when conventional radiographs are inconclusive. CT scans identified gas inclusions and soft tissue changes, while MRI provided superior visualization of spinal edema and complications such as medullary compression. Management requires a multidisciplinary approach combining timely surgical intervention with prolonged antibiotic regimens.