Silent Seeds: A Case of Delayed SCS Infection in the Setting of Immunosuppression and Recent Dental Procedure

Thursday, November 13, 2025

2:50 PM - 2:58 PM CT

Location: 301 - 302

Introduction: Spinal cord stimulators (SCS) effectively manage chronic neuropathic pain but carry a 2.8–10% risk of surgical site infections, most commonly at the implantable pulse generator pocket. Methotrexate, a widely used disease-modifying antirheumatic drug (DMARD) for rheumatoid arthritis, can increase infection risk by suppressing the immune system and impairing wound healing. Dental procedures may cause transient bacteremia, which can seed implanted devices. This case highlights delayed SCS infection in a patient on methotrexate after dental extraction.

Submitting Author(s)

RR

Renira Rugnath, MD

Resident Physician
The University of Mississippi Medical Center, Department of Anesthesiology
Jackson, Mississippi, United States

Co-Author(s)

AR

Anesh Rugnath, MD

Associate Professor for Interventional Pain Management
The University of Mississippi Medical Center Department of Anesthesiology
Jackson, Mississippi, United States
TT

Timothy Torres, MD

Fellow Physician
The University of Mississippi Medical Center
Jackson, Mississippi, United States
SK

Sathyadev Kikkeri, DO

Resident Physician
The University of Mississippi Medical Center Department of Family Medicine
Jackson, Mississippi, United States
AP

Anand Prem, MD

Professor of Anesthesiology, Interventional Pain Management
The University of Mississippi Medical Center Department of Anesthesiology
Jackson, Mississippi, United States