Daniel J. Denoon
WebMD Health News
Reviewed by Louise Chan, MD
October 4, 2012-Patients in 23 states have been warned that the spinal steroid injections they received may have given them a rare and deadly fungus. Meningitis..
According to the CDC, there have been 35 cases and “at least 5 deaths” so far, and the number of cases is expected to increase. 25 and 3 cases died in Tennessee, 4 and 1 cases in Virginia, 2 and 1 cases in Maryland, 2 cases in Florida, 1 case in North Carolina, and 1 case in Indiana. ..
All cases are linked to spinal shots called three specific lots of steroids Methylprednisolone acetate. The preservative-free drug was manufactured and placed in a syringe by a single company, the New England Compounding Center (NECC) in Framingham, Massachusetts.
All three lots have been recalled. They are 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, West Virginia.
The FDA’s warning has exceeded the three recalled lots. The FDA and CDC warn doctors, clinics, and hospitals to search shelves for NECC products and not offer them to patients until further notice. It is not yet clear whether patients who have received non-spine injections of contaminated steroids are at risk.
Since last week, the clinic has been trying to reach out to all patients who may have been infected. Neither the CDC nor the FDA knows how many patients have been shot. this is, lower back pain..
“Unfortunately, despite the current recall, we expect to see more cases as the study unfolds,” CDC Medical Director Benjamin Park, MD, said in a news conference call. “But if the patient is quickly identified and begins appropriate antifungal therapy, some unfortunate consequences may be avoided.”
Symptoms, treatment of fungal meningitis
It may take up to 4 weeks for these symptoms to appear. When they do, they start gradually and may resemble the symptoms of other conditions:
“Patients may have mild symptoms that are not typical of meningitis,” Park said. “If a patient has new or worsening symptoms, even mild ones should be evaluated immediately.”
A test of cerebrospinal fluid shows if a person is infected. The fungus that causes the infection is a strain of Aspergillus.
Treatment is not easy. Intravenous injection of one or two antifungal agents is required. Treatment should at least start in the hospital and will take several months to complete. There may be serious side effects.
Pharmacy shuts down
NECC, a dispensing pharmacy that produced contaminated steroids, voluntarily closed the door.
An FDA study found that the fungus was growing in at least one unopened vial of steroids found at the company. Testing is underway to see if it is the same strain of Aspergillus growing on the patient’s spines.
The NECC has handed over its pharmacy license to a Massachusetts pharmacy, the FDA said.
Dispensing pharmacies are primarily regulated by state pharmacy committees. The law limits FDA regulators for dispensing pharmacies that do not have to meet the extensive safety and efficacy tests required of pharmaceutical companies.
Source: Press Conference, FDA and CDC, October 4, 2012.
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