Paraspinal and Spinal Infections from Injections

To date there are 320 CDC-confirmed cases of paraspinal and spinal infections without meningitis liked to steroid injections of methylprednisolone acetate made by New England Compounding Center (NECC). Pritzker Hageman attorneys are representing dozens of people with fungal infections and are providing free consultations to fungal infection patients and their families.  You can get your free consultation here regarding your medical malpractice and product liability claims.

These cases of paraspinal and spinal infections from NECC injections are part of a larger outbreak of fungal infections, primarily fungal meningitis. The outbreak was discovered when a spinal meningitis patient had a laboratory-confirmed Aspergillus fumigatus infection. Although this first case was an Aspergillus meningitis infection, most of the cases of fungal infection have been from Exserohilum rostratum, which was also found in unopened vials of NECC methylprednisolone acetate (MPA).

Exposures have occurred through epidural, paraspinal, peripheral nerve, and intra-articular injection with NECC MPA. The period from the date of last injection with contaminated NECC MPA to the date of the first magnetic resonance imaging (MRI) finding of infection ranged from 12 to 121 days.  The CDC is advising doctors to continue to look for cases of infection in patients who had NECC MPA injections.

Since the first fungal meningitis case was reported in Tennessee on September 18, 2012, the outbreak of fungal meningitis and other fungal infections had resulted in 741 reported cases and 55 deaths in 20 states. During the first 4 weeks of the outbreak, September 7–October 5, 2012, nearly all of the reported cases nationally met the CDC case definition solely for meningitis. However, at outbreak week 5, certain states, including Michigan, began reporting cases of localized spinal and paraspinal infections, including epidural abscesses, phlegmon, arachnoiditis, discitis, or vertebral osteomyelitis. As of May 6, 2013, these localized infections, without concurrent meningitis, had accounted for 320 (43%) of the 741 total reported cases.

People from the following states have been sickened in this outbreak: Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia and West Virginia.

Case Definition

For this outbreak, the CDC case definition for spinal or paraspinal infection was as follows: osteomyelitis, abscess, or other infection (e.g., soft-tissue infection) of unknown etiology, in the spinal or paraspinal structures at or near the site of injection after epidural or paraspinal injection on or after May 21, 2012. A paraspinal injection included but was not limited to spinal facet joint injection, sacroiliac joint injection, and spinal or paraspinal nerve root or ganglion block. Laboratory tests, including direct microscopy, culture, nucleic acid amplification, and histopathology, were used to identify the specific pathogen causing infection.

The most common symptom reported among patients with spinal or paraspinal infections and meningitis was headache, followed by nausea or vomiting and back pain. Among the 139 patients with spinal or paraspinal infections without meningitis, the most common reported symptom was back pain , followed by headache and neck pain or stiff neck.

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Category: Medical Products And Procedures
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