A small number of back patients who suffered fungal meningitis attributed to contaminated epidural steroid injections suffered strokes, according to new research by Vanderbilt University medical investigators.
In a new report published in the journal JAMA Neurology, the team of researchers said three patients who suffered ischemic stroke had also been diagnosed with fungal meningitis as a result of epidural injections of contaminated methylprednisolone for low back pain.
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Last fall, the U.S. Centers for Disease Control and Prevention, in collaboration with state and local health departments, investigated a major multistate outbreak of fungal meningitis among patients who received contaminated steroid injections for the treatment of back pain or neuropathic symptoms.
Nearly 750 patients in 20 states were diagnosed with meningitis, spinal or paraspinal infections, joint infections or other complications at or near the injection site linked with compounding pharmacy formulations.
According to the CDC, the source of the contamination was a common mold found in soil and on plants — known as Exserohilum — that thrives in warm and humid climates.
Exserohilum is known to cause infection in the sinuses, lungs, lining of the heart and bone, which are thought to be more likely to occur in people with weak immune systems.
The Vanderbilt scientists said their findings could improve care for patients with meningitis and those at risk for stroke.
"This is particularly germane to neurologists because better recognition of clinical characteristics of patients with fungal meningitis and ischemic stroke will provide more timely and efficient care," they concluded.
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