Background: Percutaneous endoscopic gastrostomy (PEG) is a popular method for long-term enteral feeding. Our aim was to determine potential risk factors for adverse events related to PEG, as well as consequent prolonged hospitalization. Methods: Data were retrospectively collected from the admission records of a tertiary center between July 2015 and June 2018. Possible predictors of the 3 following outcomes were evaluated: minor PEG-related adverse events, major PEG-related adverse events, and length of hospital stay. Data were tested for correlation using the Spearman coefficient and for association using Kruskal-Wallis tests for significance. Results: A total of 362 admissions involving 146 patients were included in the study. Of the admissions, 221 (61.0%) had only minor adverse events, 100 (27.6%) had only major adverse events, and 41 (11.3%) had both. Eighty (22.1%) had PEG-site infection and 128 (35%) had aspiration pneumonia. Serum albumin levels at presentation were negatively correlated with the length of hospitalization (P<0.001), which also differed between patients presenting with major and minor adverse events (P<0.001 and P=0.026). The Charlson comorbidity index was positively correlated with the duration of hospitalization (P<0.001). Higher index scores were found more among patients presenting with aspiration pneumonia (P=0.004) and lower scores were found among patients presenting with PEG site infection and inadvertent PEG removal compared with those presenting with a major complication (P<0.001). Conclusion: The patient’s general medical condition and nutritional status are the greatest risk predictors for developing adverse events related to their PEG feeding, as well as a consequent extended hospital stay.

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Background: Streptococcus suis is a zoonotic infection known to cause meningitis and sepsis, in addition to several other rare manifestations. Infection with this organism is rare in the absence of pork ingestion or a handling history. Case presentation: The authors report the case of a 62-year-old male with no animal contact history, who presented with symptoms of urinary tract infection. It was his second infection over the course of 2 years. His urine culture was positive for Escherichia coli but his blood culture was positive for S. suis. Ultrasound of the abdomen ruled out underlying predisposing urinary pathology. However, it did show several heterogeneous liver masses with abnormal vascularity. A follow-up abdominal CT revealed a malignant neoplastic process involving the sigmoid colon with metastatic liver lesions. Colonoscopy demonstrated a fungating mass at the sigmoid colon and biopsies revealed a moderately differentiated adenocarcinoma. Conclusion: This case suggests the possibility of associated colon cancer in patients presenting with S. suis with no explicit history of animal or pork contact. It also proposes the existence of an association between colon cancer with Streptococcus species other than bovis.