No meningitis cases among patients at Durham clinic

State’s two meningitis cases are elsewhere

jprice@newsobserver.comOctober 8, 2012 

  • Fungal meningitis What is meningitis? Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection frequently with bacteria or a virus, but meningitis can also be caused by less common pathogens such as fungi. The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis. What is fungal meningitis? Fungal meningitis occurs when the protective membranes that cover the brain and spinal cord are infected with a fungus. Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body, as a result of the fungus being introduced directly into the central nervous system or from infected tissue next to the central nervous system. Is fungal meningitis common after epidural injections? Epidural injections are generally very safe procedures, and complications are rare. Fungal meningitis is an extremely rare cause of meningitis overall, including after epidural injections. The type of epidural medication given to patients affected by this outbreak is not the same type of medication as that given to women during childbirth. What are fungal meningitis symptoms? Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, but they often appear more gradually and can be very mild at first. In addition to typical meningitis symptoms, such as headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might have just one or two of these symptoms.

Neither of the two confirmed cases of fungal meningitis found in North Carolina as part of a national outbreak was among patients at an orthopedic clinic in Durham, state officials said Monday.

Fungal meningitis can’t be transmitted from one person to another and is rare. But the number of new cases has been rising almost daily; as of Monday afternoon, eight people had been killed and nearly 100 others sickened in eight states, according to the Centers for Disease Control and Prevention.

The CDC has linked several of the cases with three potentially contaminated batches of the steroid methylprednisolone acetate, which were injected into patients at a host of health care facilities, including three in North Carolina. But the only one in the Triangle, N.C. Orthopedic Center in Durham, was injecting the medicine into joints, while every diagnosed case tied to the medicine involved injections directly into the spine.

The other two health care facilities in the state identified by the CDC as having used the potentially tainted steroid are the High Point Surgery Center and the Surgery Center of Wilson. Spokeswomen at both said Monday that all patients who may have been injected with medicine from those batches had been notified, including 70 who had been treated at the High Point clinic and 26 at Wilson.

Duke University’s health care system, which owns the N.C. Orthopedic Clinic, released a statement Monday that said it had reached out to all the patients who potentially received the recalled steroid and had talked with all but a few.

Dr. Zack Moore, a medical epidemiologist with the N.C. Division of Public Health, confirmed Monday that the Durham clinic had not been tied to either of the state’s cases, but he declined to say which clinic each of the patients had visited, citing the need to protect their identities.

Meningitis is an inflammation of the protective sheaths around the brain and spinal cord. The fungal version is less common than types caused by bacteria or virus.

Time lag for symptoms

The symptoms of fungal meningitis can begin slowly, and can include headache, fever, nausea, and stiffness of the neck, confusion, dizziness, and even problems tolerating bright light.

The suspect batches of the medicine were distributed in 23 states and recalled Sept. 26.

But the illness can take weeks to develop, and CDC officials have said they expect more cases to emerge.

CDC officials have not flatly said that the medicine is to blame, but rather that they are continuing a multistate investigation into the cause.

Price: 919-829-4526

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