Fungal Meningitis

Outbreak of fungal meningitis Disease outbreaks are one of the biggest concerns in the world, because they can happen out of nowhere and cause a lot of damage before being dealt with. The United States faced such an outbreak when a, supposedly safe, pain relief medication resulted in an outbreak of fungal meningitis. Fungal meningitis is a rare infection that occurs mostly in patients with compromised or suppressed immune systems; however, the epidural steroid injections used to treat inflammation were contaminated with Exserohilum rostratum and injected directly into the patient’s spinal fluid, giving the fungus ample opportunity to cause a multistate outbreak of the disease (Andes and Casadevail, 2013). This unfortunate outbreak was traced back, by the CDC, to poor manufacturing practices, equipment designs and sterilization procedures performed at the New England compounding center (NECC) where the epidural steroids were made (Andes and Casadevail, 2013). The real complication in this whole matter was that, most clinicians were ill-prepared for rare fungal infections and it took them from May 2012 to late September 2012 to realize a pattern in patient symptoms and take appropriate action. By mid-October the FDA issued a warning against the contaminated drugs and NECC, in response to the outbreak, voluntarily recalled three lots of their drug from 75 medical facilities in 23 states. Unfortunately, in that period of confusion, out of 15000 exposed patients, 64 people died and 750 people had to be treated for meningitis and other infections (Andes and Casadevail, 2013).

Causative agent: Exserohilum rostratum Although there were a few different fungal species identified during the outbreak, Exserohilum rostratum was the pre-dominant disease causing pathogen. This came as a shock to many medical and scientific personnel because Exserohilum rostratum is a species with very low pathogenicity, which means it was never really a problem to humans and even

References: Cited Andes D and Casadevali A. 2013. Insights into fungal pathogenesis from the iatrogenic epidemic of Exserohilum rostratum fungal meningitis. Journal of fungal genetics and Biology. Vol 61: 143-145 Centers for Disease Control and Prevention. (2013). CDC Update on the Multistate Outbreak of Fungal Meningitis and Other Infections: One Year Later. Retrieved from http://www.cdc.gov/media/releases/2013/s1023-multistate-outbreak.html Frazer J. (2012 November 12th). Fungal Meningitis Pathogen Discovers New Appetite for Human Brains. Scientific American. Retrieved from http://www.scientificamerican.com/article.cfm?id=fungal-meningitis-pathogen-discovers-new-appetite-human-brains Ginsberg L. 2004. Difficult and Recurrent Meningitis. Journal of Neural Neurosurgical Psychiatry. Vol 75: 16-21. Kauffman C A, Pappas P G and Patterson T F. 2013. Fungal Infections Associated with Contaminated Methylprednisolone Injections. The New England Journal of Medicine. Vol 368: 2495-2500.