Meningitis and Brain Abscess Presenting with Epistaxis in a Woman with Prior Head and Neck Cancer

It is estimated that more than 60% of people have epistaxis in their lifetimes, and as such it is a common complaint encountered in emergency medicine. Although epistaxis is usually self-limited and benign, it can occasionally be a sign of serious underlying pathology. We report a case of epistaxis secondary to invasive squamous cell cancer, ultimately leading to pneumocephalus and brain abscess. We recommend a low threshold for neuroimaging in patients with known prior head and neck cancers presenting with epistaxis, as even resolved epistaxis may be related to serious pathology.