Officials at the Centers for Disease Control and Prevention in Atlanta and the U.S. Food and Drug Administration in Washington are coordinating a multistate investigation of meningitis among patients who received epidural steroid injections -- medication injected into the spine to help treat back pain.
"Several of these patients have had strokes related to the meningitis. In several patients, the meningitis was found to be caused by a fungus that is common in the environment but rarely causes meningitis," CDC officials said in a statement. "This form of meningitis is not contagious. The source of the fungus has not yet been identified, and the cause of infections in the other patients is still being assessed."
These cases are associated with a potentially contaminated medication. Investigation into the exact source is ongoing but interim data indicate all infected patients received injection of preservative-free methylprednisolone acetate prepared by New England Compounding Center in Framingham, Mass., the CDC said.
The lots of the medication given to patients have been recalled by the manufacturer in the following states: California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas and West Virginia.
"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 CDC said. "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."
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 by direct extension from an infected body site next to the central nervous system, the CDC said.