Two cases of fungal meningitis identified in N.C.

Two cases related to contaminated steroid injections have been reported

By Matt CaulderOctober 7, 2012 

  • About the disease Fungal meningitis is a rare form of meningitis that is spread through the blood to the spinal cord. Meningitis is the inflammation of the protective membrane over the brain and spinal cord. Fungal meningitis is not contagious. Symptoms include fever, headache, stiff neck, nausea and vomiting, sensitivity to light and altered mental status.

— Two cases of fungal meningitis related to contaminated steroid injections have been reported in North Carolina, according to a statement updated Sunday by the Centers for Disease Control and Prevention in Atlanta.

Duke Medicine representatives released a statement Friday evening identifying the North Carolina Orthopedic Clinic as one of the three North Carolina outpatient facilities to have received the contaminated steroid linked with 91 cases of fungal meningitis affecting nine states that has left seven people dead nationwide.

Several of the patients who received the epidural injections have had strokes related to the meningitis, according to a CDC statement.

Duke Medicine has evaluated the supply chain to its clinics and identified the orthopedic clinic as being the only Duke facility to use the contaminated steroids.

Duke Medicine has been working with the clinic to identify and notify all patients who received the recalled medication.

All reported cases of fungal meningitis in the U.S. because of the contaminated steroids have stemmed from epidural injections into a patient’s spine, but Duke Medicine has said that the use of the steroid in its clinic was limited to joint injections rather than epidural injections.

“Our findings to date indicate that this product has not been used in our hospitals or ambulatory surgery centers; however, our investigations will continue to ensure the safety of our patients,” a Duke Medical representative said in a statement.

According to the CDC statement, three outpatient facilities in North Carolina received the tainted medication: the North Carolina Orthopedic Clinic, Eastern Regional Surgical Center in Wilson, and High Point Surgery Center of High Point, a subsidiary of High Point Regional Hospital and Health System.

High Point Surgery Center identified 70 patients who received the epidural steroid injections who have since been notified and given instructions to follow if symptoms of meningitis should occur, said Tracie Blackmon, spokesperson for High Point Regional Hospital and Health System.

Symptoms of fungal meningitis include headache, fever, nausea, stiffness of the neck, confusion, dizziness and sensitivity to bright lights, according to the CDC statement.

Any patients found to have fungal meningitis will be treated with antibiotics specific to their individual case.

According to the CDC, this form of meningitis is not contagious.

The contaminated medicine, a methylprenisone acetate injectable steroid, was manufactured by New England Compounding Center based in Massachusetts.

The company is a certified external compounding pharmacy that supplies pharmaceuticals to numerous states including North Carolina.

States are affected as far south as Florida and as far west as Nevada.

Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord known as meninges.

The inflammation of the meninges resulting in meningitis is usually caused by a virus or bacteria but is less commonly caused by a fungus.

The severity of the disease varies based on the source of the meningitis, which makes identifying the exact cause very important.

Fungal meningitis forms when a fungus travels through the bloodstream to the central nervous system and reaches the brain and spinal cord, or in the case of an epidural injection is directly introduced to the spine.

It is very rare for an epidural injection to cause fungal meningitis, which is a rare type of meningitis.

According to the CDC, epidural injections are generally very safe procedures.

The type of contaminated steroid used to relieve pain is not the same type of steroid used during childbirth, according to the CDC.

Caulder: 919-829-4758

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