Second Illness Is Infecting Those Struck by Meningitis

[Shiloh]

Source: http://www.nytimes.com/2012/11/03/h...cts-meningitis-sufferers.html?ref=health&_r=0

Second Illness Is Infecting Those Struck by Meningitis
By DENISE GRADY
Published: November 2, 2012


Just when they might have thought they were in the clear, people recovering from meningitis in an outbreak caused by a contaminated steroid drug have been struck by a second illness.

The new problem, called an epidural abscess, is an infection near the spine at the site where the drug ? contaminated by a fungus ? was injected to treat back or neck pain. The abscesses are a localized infection, different from meningitis, which affects the membranes covering the brain and spinal cord. But in some cases, an untreated abscess can cause meningitis. The abscesses have formed even while patients were taking powerful antifungal medicines, putting them back in the hospital for more treatment, often with surgery...

 

[Catbird]

Re: Second Illness Is Infecting Those Struck by Meningitis

The comments made by CDC's Dr. Shiller are being widely reported but I haven't been able to find anything on the CDC site as a source. I'll continue watching the site to see if we find a transcript of his complete remarks.


Some infections thwart treatment in fungal meningitis outbreak

"As the death toll and the case counts continued to climb Monday in an outbreak of fungal meningitis tied to tainted pain shots, health officials admit they’ve been stymied in their best efforts to treat patients.

“I don’t think we have a very good handle on exactly what is happening or how this is playing out,” said Dr. Tom Chiller, deputy chief of the mycotic diseases branch at the Centers for Disease Control and Prevention.

Thirty people have died and 419 have developed fungal meningitis or joint infections in 19 states after receiving injections of contaminated steroid drugs earlier this year, the CDC reported Monday.

Those numbers include dozens of patients who have developed abscesses at the infection site or another condition called arachnoiditis, an inflammation of the delicate membranes that surround and protect the nerves of the spinal cord.

In Michigan, for instance, which has logged the most cases -- 119, plus seven deaths -- 61 patients have developed fungal meningitis; 51 who developed epidural abscesses, six joint infections and one stroke.

“In some cases, those abscesses have developed into meningitis,” said Angela Minicuci, a spokeswoman for the Michigan Department of Community Health.

What’s particularly alarming is that some patients have become sicker even though they’ve been taking powerful antifungal drugs aimed at wiping out the black mold Exserohilium, which has been responsible for most of the illnesses.

“What we do know from hearing from a few centers is that around a third of patients with meningitis are having some sort of disease progression,” Chiller said.

It’s not clear why some patients aren’t responding to the therapy. The fungi are difficult to treat, Chiller said, but tests showed that the organisms should have been killed by the drugs. Doctors don’t know whether the problem is the natural progression of the disease itself, or perhaps the body’s immune system kicking into action, Chiller said.

“Are we actually killing the fungi and this is a reaction?” he asked. “It’s not responding to therapy that well, or it’s responding very slowly.”

For patients who already have been affected, that means they can expect a protracted recovery from the fungal infections. “It will be a long-term therapeutic management issue,” Chiller said..."

 

[Pathfinder]

Re: Second Illness Is Infecting Those Struck by Meningitis

Fungal meningitis victim hopes Congress hears: 'It's torturous'
<TIME pubdate="" datetime="2012-11-13T07:54:17-05:00">
1 hour ago
...
Not only did Snopkowski contract life-threatening fungal meningitis, which causes inflammation of the membranes that protect the brain and spinal cord, but, like growing numbers of outbreak patients, she also has developed arachnoiditis, a painful, hard-to-treat infection of the nerve roots at the base of her spinal cord. Other patients -- perhaps up to a third of victims -- have also developed abscesses at their injection sites, medical experts say.

Worse, doctors aren?t quite sure what to do about it.

?We?ve never seen this disease before; it?s never been described,? said Dr. Anurag Malani, the infectious disease expert at St. Joseph Mercy Ann Arbor who is treating Snopkowski and others. ?The story is being told every day and we continue to turn the page.?
...
Snopkowski was placed on powerful antifungal drugs and at first seemed to respond. After 11 days in the hospital, she was sent home, but she was back within a week in unbearable pain.

That?s when doctors found the second infection. Malani, the infectious disease expert, said they can?t drain it, they can?t operate on it and it is responding slowly to the antifungal drugs.

Snopkowski?s treatment is also complicated because she had a bad reaction to one of the drugs, amphotericin B, and her body seems to metabolize the other commonly used medication, voriconazole, too quickly.

?We have to do some devious things to keep her levels up,? said Dr. Carol Kauffman, a University of Michigan expert in fungal infections who is consulting with St. Joseph Mercy on the outbreak, in addition to advising the U.S. Centers for Disease Control and Prevention.
...

Full text:
http://vitals.nbcnews.com/_news/201...tis-victim-hopes-congress-hears-its-torturous

 

[Shiloh]

Re: Second Illness Is Infecting Those Struck by Meningitis

Source: http://www.myfoxtwincities.com/stor...l-diseases-emerge-in-tainted-steroid-patients


2nd wave of fungal diseases emerge in tainted steroid patients
Posted: Nov 15, 2012 4:38 PM EST Updated: Nov 15, 2012 4:39 PM EST
by Shelby Capacio - email

Minnesota Department of Health is urging patients who received steroid injections from the Massachusetts pharmacy linked to an outbreak of fungal meningitis to remain vigilant as more diseases linked to the drugs emerge.

States across the country are seeing a second wave of fungal sicknesses among patients who received medicines manufactured at the New England Compounding Center.

In Minnesota, a woman in her 20s was found to have a fungal infection inside her bones that is consistent with osteomyelitis. She is not currently hospitalized.

This latest case marks the 13th infection in Minnesota related to the contaminated drugs. Of the previous cases, one other Minnesota patient also experienced a bone infection...

 

[Shiloh]

Re: Second Illness Is Infecting Those Struck by Meningitis

Source: http://www.freep.com/article/201211...ural-abscess-cases-linked-meningitis-outbreak

86 Michigan epidural abscess cases linked to meningitis outbreak
November 17, 2012 |
By Ann Zaniewski
Free Press Staff Writer


Michigan Department of Community Health officials reported Friday the state has more epidural abscess cases than meningitis cases related to the ongoing investigation of a fungal meningitis outbreak...

 

[Emily]

Re: Second Illness Is Infecting Those Struck by Meningitis

http://www.tennessean.com/article/20121120/NEWS07/311200083/Meningitis-outbreak-State-warns-new-fungal-infections?odyssey=nav|head

Meningitis outbreak: State warns of new fungal infections
7:51 PM, Nov 20, 2012
[snip]
Patients need to be alert, because some of the symptoms might not initially appear to be connected to the epidural steroid injections, she said.

?If they have had severe constipation or urinary retention or urinary or fecal incontinence, those symptoms and signs people may not necessarily think may be related to this ? and we want to make sure people are aware of those,? she said.

 

[Shiloh]

Re: Second Illness Is Infecting Those Struck by Meningitis

Source: http://www.cbsnews.com/8301-204_162...n-non-meningitis-infections-tied-to-outbreak/


Ryan Jaslow /
CBS News/ November 21, 2012, 3:55 PM
CDC reports increase in non-meningitis infections tied to outbreak

...The CDC announced Tuesday that it is still receiving reports of infections more than seven weeks after the September recall of more than 17,000 vials of injections of the steroid made by the NECC; however, the pattern now reflects an uptick infections at the site where patients received the injection. Those infections include epidural abscesses, phlegmon (soft tissue infection), discitis (infection of disc space between vertebrae), vertebral osteomyelitis (a bone infection) or arachnoiditis (swelling of one of the spinal cord membranes).

The infections are being found in both people who have already been diagnosed with fungal meningitis and people who haven't been. The CDC said Wednesday that there may not be new infections in those people, but because the fungus tied to the outbreak -- Exserohilum rostratum -- is slow-growing, the infections may have been building up...

 

[Shiloh]

Re: Second Illness Is Infecting Those Struck by Meningitis

Source: http://www.cbsnews.com/8301-18563_1...fections-plague-meningitis-outbreak-patients/


November 26, 2012 7:07 PM
Secondary infections plague meningitis outbreak patients
By Jonathan LaPook

CBS News) - The meningitis outbreak claimed two more lives in the past week.

The tainted steroid produced by the New England Compounding Center has infected 496 people in 19 states. The latest deaths bring the toll to 36.

But now fears of secondary infections in survivors are looming...