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We present the first reported case of peritoneal dialysis-associated peritonitis caused by Staphylococcus pseudintermedius, an organism that had been misclassified as S. aureus in the past. S. pseudintermedius is well recognized in the veterinary literature and noted as flora in the mouth, nares, and anus of domesticated animals. It has been associated with soft tissue infections in pets and is now being reported in increased frequency as the causative agent in various human infections. It also has a different antibiotic sensitivity profile. The patient had close contact with her pet dog and was successfully treated with intravenous antibiotics in the hospital followed by oral doxycycline for 10 days after discharge. The patient has not had any recurrent infection after obtaining and applying appropriate hygienic education and precautions.

Abstract. Introduction:. Spinal cord stimulation has been shown to be beneficial in various postsurgical neuropathic pain syndromes, but the already small cervical epidural space due to epidural fibrosis makes cervical spinal cord stimulator placement very difficult. We present a case of successful cervical cord stimulator implantation in a patient with a history of anterior cervical discectomy and fusion, posterior cervical fusion, and significant epidural fibrosis. Methods:. A 48-year-old woman with a history of type 2 diabetes, nonalcoholic steatohepatitis, and fibromyalgia presented with trauma-induced cervicalgia and bilateral upper extremity radiculopathy. Results:. In a 4-day trial of stimulation, she reported an 80% reduction of her pain and significant improvement in her quality of life. Discussion:. Although anecdotal evidence and case series have shown spinal cord stimulation to be successful in cervical failed back surgery syndrome, we are the first to discuss the technical challenges and complications associated with epidural fibrosis.

Abstract. Introduction:. Peripheral nerve stimulators have emerged as a new generation of advanced modalities to treat chronic pain and avoid opioids. They transmit electrical stimulation through implanted leads and wireless, wearable, external generators. Common complications include infection, nerve damage, and migration of stimulating leads. This article describes 2 cases of complications from lead migration. Methods:. Case 1 describes a 61-year-old man with chronic groin pain who underwent an uncomplicated ultrasound-guided ilioinguinal peripheral nerve lead implantation. Case 2 describes a 54-year-old woman with left shoulder pain who underwent an uncomplicated ultrasound-guided percutaneous lead placement near the axillary nerve through a deltoid approach. Both peripheral nerve stimulators were confirmed with fluoroscopy, and each patient was followed up every 2 months for the following 2 years. Results:. Both patients experienced lead migration to the skin resulting in erythema and need for lead removal. Initial unsuccessful removal by traction resulted in retained fragments and need for open surgical removal. Discussion:. Neurologic complications of peripheral nerve stimulator implantation are rare, but device-associated complications, specifically lead migration, remain a source of long-term problems that can result in decreased coverage of the intended neural target. Conclusion:. Thorough patient education, early postimplantation assessment, and extended routine follow-up are necessary to decrease lead-associated complications. If migration does occur, the potential impact of scar tissue on removal should be considered.

Abstract Objective Hyperglycemia is an independent risk factor in hospitalized patients for adverse outcomes, even if patients are not diabetic. We used continuous glucose monitoring to evaluate whether glycemic control (hyperglycemia) in the first 72 h after an intensive care admission was associated with the need for admission to a post discharge long-term medical facility. Results We enrolled 59 coronary artery bypass grafting patients. Poor glycemic control was defined as greater than 33% of continuous glucose monitoring values 180 mg/dL (group 1); and then these patients were reevaluated with a less strict definition of poor glycemic control with greater than 25% of continuous glucose values 180 mg/dL (group 2). In group 1 4/10 (40.0%) whose glucose was not well controlled went to an extended care post discharge facility as opposed to 6/49 (12.2%) that were well controlled. In reevaluation as group 2, 5/14 (35.7%) whose glucose was not well controlled went to an extended care post discharge facility as opposed to 5/45 (11.1%) who were well controlled. Admission to a post discharge facility was increased in patients with poor glycemic control p = 0.045 and p = 0.042 for group 1 and group 2, and with odds ratios of 4.8 (95% CI 1.0–22.5) and 4.4 (95% CI 1.0–19.4), respectively.