Necrotizing fasciitis (NF) is a critical and rapidly progressive infection of the skin and soft tissue, and it is associated with a high mortality rate. NF of the cervicofacial region is uncommon due to the rich vascular supply of the head and neck, which promotes an efficient immune response to infection. Patients who are immunocompromised or have comorbidities affecting the vasculature, such as diabetes mellitus or peripheral vascular disease, are at an increased risk of more severe disease and outcome. Cervicofacial necrotizing fasciitis (CNF) is most frequently attributed to mucosal damage, such as those related to dental infections or local trauma including medical procedures. Due to its ability to quickly spread to the neck and mediastinum, CNF must be diagnosed and treated expeditiously. In this report, we present a case of a 28-year-old female with a past medical history significant for obesity and tobacco abuse who presented to the emergency department (ED) with fever, left-sided facial pain, cervical pain, and swelling. She had worsening symptoms despite current treatment with clindamycin for a dental abscess. A CT scan of the head and neck revealed an odontogenic abscess complicated by CNF. Intravenous antibiotics were initiated and she underwent prompt surgical intervention. She remained nasally intubated following her surgery due to concern for postoperative edema leading to airway compromise. Following extubation, she experienced an uncomplicated recovery. This case demonstrates that NF is a complication of dental infection that may occur even in young and relatively healthy patients. Additionally, due to the swiftly destructive nature and high mortality rate of CNF, early diagnosis and aggressive medical and surgical therapy are essential to reduce morbidity and mortality.

Approximately one in five adults in the United States experiences chronic pain. Over the last 50 years, spinal cord stimulation has become increasingly recognized as a minimally invasive, efficacious treatment modality for the management of chronic pain. The authors report a case study of a 46-year-old female in the first documented spinal cord stimulation simultaneously targeting intractable neuropathic and visceral pain caused by post-laminectomy syndrome and chronic pancreatitis, respectively. This case study demonstrates near-total relief of the patient's neuropathic low back/leg pain and visceral epigastric pain, showing evidence of potential clinical usefulness for spinal cord stimulation as a treatment option in patients who present with a combination of visceral and somatic pain symptoms.

Patients who present with acute myocardial infarction are often urgently evaluated for possible revascularization via coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), or medical therapy alone. CABG has been shown to provide symptomatic relief as well as increased long-term survival for patients with multivessel coronary artery disease (CAD). Though venous grafts can be used to revascularize the ischemic territory, long-term patency is most successful when using pedicled coronary grafts such as the left internal mammary artery (LIMA) or right internal mammary artery (RIMA) graft. Only a fraction of patients who undergo a RIMA or LIMA will occlude their graft, and mid-graft lesions presumed secondary to atherosclerosis are even rare. For our case report, we evaluate a 72-year-old female who has had a very rare acute coronary occlusion of her mid-RIMA graft resulting in an acute apical left ventricular infarct. A heart catheterization confirmed a 100% thrombotic occlusion of the mid-RIMA-LAD, which was stented with a 2.5 x 20 mm drug-eluting stent.