2017-09-19T10:05:38+00:00Pritzker Hageman, P.A.Fred Pritzker 45 S 7th St, #2950 Minneapolis, MN, 55402 U.S.A +1.612.338.0202

Fungal Meningitis from Steroid Injections

CDC Outbreak Image
Antifungal drug susceptibility testing during the 2012 multistate outbreak investigation.

A multi-state outbreak of meningitis among patients who received epidural steroid injections is growing daily. To date, there are over 700 CDC-confirmed cases of fungal infection in 20 states. 377 of these people contracted fungal meningitis, and 345 of them contracted other infections, including epidural abscess and osteomyelitis (fungal infection in the bone). The states involved include the following: Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas and Virginia. 50 people have died. Fred and his Bad Bug Law Team represent people throughout the United States.

Many of the victims of this outbreak also had strokes that are believed to have resulted from their infection.

All infected patients received injection with preservative-free methylprednisolone acetate prepared by New England Compounding Center (NECC), located in Framingham, MA. The lots of medication that were used on infected patients have been recalled. The lots are:

  • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #[email protected], BUD 11/17/2012
  • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #[email protected], BUD 12/26/2012
  • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #[email protected], BUD 2/6/2013

Investigation of the Outbreak

On September 21, 2012, CDC was notified by the Tennessee Department of Health of a patient with the onset of meningitis approximately nineteen days following epidural steroid injection at a Tennessee ambulatory surgical center (ASC). All initial cultures of cerebrospinal fluid (CSF) and blood were negative; subsequently the patient had Aspergillus fumigatus isolated from CSF by fungal culture.

On September 28, 2012, investigators identified a case outside of Tennessee (North Carolina), possibly indicating contamination of a widely-distributed medication. Fungus has been identified in specimens obtained from three of these additional patients, one of whom also had Propionobacterium acnes, of unclear clinical significance, isolated from a post-mortem central nervous system specimen.

Infected patients have presented approximately one to four weeks following their injection with a variety of symptoms including: fever, new or worsening headache, nausea, and/or new neurological deficit (consistent with deep brain stroke). Some of these patients’ symptoms were very mild in nature. Cerebrospinal fluid (CSF) obtained from these patients has typically shown elevated white cell count (with a predominance of neutrophils), low glucose, and elevated protein.

CDC-Confirmed Case Definition

  1. A person with meningitis of sub-acute onset (1-4 weeks) following epidural injection after May 21, 2012.
  2. A person with basilar stroke 1-4 weeks following epidural injection after May 21, 20122, who has not received a diagnostic lumbar puncture.
  3. A person with evidence of spinal osteomyelitis or epidural abscess at the site of an epidural injection diagnosed 1-4 weeks after epidural injection after May 21, 2012.
  4. A person with septic arthritis3 diagnosed 1-4 weeks following steroid joint injection after May 21, 2012.

For the purpose if this case definition, clinically diagnosed meningitis means 1 or more of the following symptoms: headache, fever, stiff neck, or photophobia and a cerebrospinal fluid (CSF) profile consistent with meningitis (pleocytosis +/-  low glucose, elevated protein). Clinically diagnosed septic arthritis means new or worsening pain with presence of effusion or new or worsening effusion.

What Should Patients Be Doing?

If you have received a steroid injection, and you are experiencing symptoms such as new or worsening headache, fever, neck stiffness, or pain at the injection site, contact your physician to determine if you have received one of the recalled products and to receive further evaluation.

Our meningitis lawyers represent sick people and their families nationwide in personal injury and wrongful death lawsuits against manufacturers, distributors, clinics and others. Contact Fred and his Bad Bug Law Team for a free consultation here.

List of Healthcare Facilities which Received Lots of Methylprednisolone Acetate (PF) Recalled from New England Compounding Center on September 26, 2012

CYPRESS SURGERY CENTER -DBA559 740 4094 -VISALIA- CA

ENCINO OUTPATIENT SURGICENTER-818-986-1037-ENCINO-CA

UKIAH VALLEY MEDICAL CENTER-707 463 7345-UKIAH- CA

UNIVERSAL PAIN MANAGEMENT – 661-267-6876-X166 – PALMDALE – CA

INTERVENTIONAL SPINE AND SPORTS MED – 203 598 7246 -MIDDLEBURY – CT

FLORIDA PAIN CLINIC-352-237-5906O-CALA-FL

INTERVENTIONAL REHAB CENTER-850 484 8800-PENSACOLA-FL

MARION PAIN MANAGEMENT CENTER – 352 622 1845  – OCALA -FL

NORTH COUNTY SURGICENTER – 561 626 6446 – PALM BEACH GARDENS -FL

ORLANDO CENTER FOR OUTPATIENT SURGERY – 407-426-8331 – ORLANDO – FL

PAIN CONSULTANTS OF WEST FLORIDA – 850 494 0000 – PENSACOLA – FL

SURGERY CENTER OF OCALA – 352-237-5906 – OCALA – FL

SURGICAL PARK CENTER -305-271-9100 x226 – MIAMI – FL

FORSYTH STREET AMBULATORY SURG. CTR. – 478-749-1610 – MACON – GA

PAIN SPECIALISTS OF IDAHO-208 522 7246-IDAHO FALLS-ID

WALTER KNOX MEMORIAL HOSPITAL – 208-365-3561 x3342 – EMMETT – ID

APAC CENTERS FOR PAIN MANAGEMENT – 708-483-7007 – WESTCHESTER-IL

APAC CENTERS FOR PAIN MANAGEMENT – 773-935-2760 – CHICAGO – IL

THOREK MEMORIAL HOSPITAL-773 975-6734-CHICAGO-IL

AMBULATORY CARE CENTER LLC-812 475 1800-EVANSVILLE-IN

FORT WAYNE PHYSICAL MEDICINE-260-436-9337-FORT WAYNE-IN

OSMC OUTPATIENT SURGERY CENTER – 574-266-4173-ELKHART-IN

SOUTH BEND CLINIC-574-237-9372-SOUTH BEND-IN

UNION HOSPITAL–812 238 4964-TERRE HAUTE-IN

WELLSPRING-812-376-0700-COLUMBUS-IN

BALTIMORE PAIN MANAGEMENT-410 682-5040-BALTIMORE-MD

BERLIN INTERVENTIONAL PAIN MANAGEMENT -410 641 3759-BERLIN-MD

BOX HILL SURGERY CENTER-410 877 8141-ABINGDON-MD

GREENSPRING SURGERY CENTER-410 653 0077-BALTIMORE-MD

HARFORD COUNTY ASC, LLC-410 538 7000-EDGEWOOD-MD

PAIN MEDICINE SPECIALISTS-410 825 6945-TOWSON-MD

SURGCENTER OF BEL AIR-410 638 5523-BEL AIR-MD

MICHIGAN NEUROSURGICAL INST.-810 606 7112-GRAND BLANC-MI

MICHIGAN PAIN SPECIALISTS-734 995 7246-BRIGHTON-MI

NEUROMUSCULAR & REHABILITATION – 231 935 0860-TRAVERSE CITY-MI

SOUTHEAST MICHIGAN SURGICAL HOSPITAL – 586-427-1000- WARREN- MI

MAPS-EDINA MEDICAL PAIN CLINIC-763 537 6000-MINNEAPOLIS-MN

MAPS-MEDICAL ADVANCED PAIN-763 537 6000-FRIDLEY-MN

MEDICAL ADVANCED PAIN SPECIALISTS* – 763-537-6000 x238 – SHAKOPEE-MN

MEDICAL ADVANCED PAIN SPECIALISTS – 763 537 6000-MAPLE GROVE-MN

MINNESOTA SURGERY CENTER-763-767-7139-EDINA-MN

MINNESOTA SURGERY CENTER-763 537 6000-MAPLE GROVE-MN

HIGH POINT SURGERY-336 878 6048-HIGH POINT-NC

NORTH CAROLINA ORTHOPEDIC CLINIC – 919 403 5148-DURHAM-NC

SURGERY CENTER OF WILSON-252-237-5649-WILSON-NC

DR. O’CONNELL’S PAIN CARE CTR-603-335-5070-MERRIMACK-NH

DR. O’CONNELL’S PAINCARE CENTERS, INC -603 692 3166-SOMERSWORTH-NH

CENTRAL JERSEY ORTHOPEDICS SPECIALISTS PC – 908 561 2122 -SOUTH PLAINFIELD- NJ

EDISON SURGICAL CENTER-732 452 0123-EDISON-NJ

IF PAIN ASSOCIATES / ISAIAH FLORENCE – 201 287 1100-TEANECK- NJ

PREMIER ORTHOPEDICS SURG. ASSOC., LLC – 856 690 1750-VINELAND- NJ

COMPREHENSIVE PAIN MANAGEMENT -973 796 5216-SPARTA-NJ

SOUTH JERSEY HEALTH CARE-856 363 1558-ELMER-NJ

SOUTH JERSEY HEALTHCARE-856-641-7557-VINELAND-NJ

SAHARA SURGERY CENTER-702-362-7874-LAS VEGAS-NV

BUTANI, SUNIL H. PHYSICIAN- PC516 747 5042-MINEOLA-NY

OBOSA MEDICAL SERVICES-914-530-2323-MOUNT VERNON-NY

ROCHESTER BRAIN AND SPINE-585 334 5560-ROCHESTER-NY

BKC PAIN SPECIALISTS,LLC-740-387-7246-MARION-OH

CINCINNATI PAIN MANAGEMENT-513 891 0022-CINCINNATI-OH

MARION PAIN CLINIC-740-375-0200-MARION-OH

ALLEGHENY PAIN MANAGEMENT-814-940-2000 X 500-ALTOONA-PA

SOUTH HILLS PAIN & REHAB ASSOC.-412 469 7722-JEFFERSON HILLS-PA

NEW ENGLAND ANESTHESIOLOGY (NEA)-401-490-7530-WARWICK-RI

OCEAN STATE PAIN MANAGEMENT-401 766 7700-WOONSOCKET-RI

OCEAN STATE PAIN MANAGEMENT-401 884 6070-EAST GREENWICH-RI

INTERVENE MD-843-216-4844-MOUNT PLEASANT-SC

PCA PAIN CARE CENTER-865 835 5196-OAK RIDGE-TN

SPECIALTY SURGERY CENTER-931-484-2500 x125-CROSSVILLE-TN

ST. THOMAS OUTPATIENT NEUROSURGIACL-615 341 3433-NASHVILLE-TN

DALLAS BACK PAIN MANAGEMENT-214 445 5077-DALLAS-TX

HARRIS METHODIST SOUTHLAKE CENTER – 817 748 8778 -SOUTHLAKE – TX

INSIGHT IMAGING-ROANOKE- 540 581 0882 – ROANOKE – VA

NEW RIVER VALLEY SURGERY CENTER – 540 639 5888 – CHRISTIANSBURG – VA

PARS INTERVENTIONAL PAIN – 304 865 7277 – PARKERSBURG – WV