People recovering from the fungal meningitis outbreak are being hit with a second illness, according to officials. The new medical problem is an epidural abscess, which was caused by the same steroid.
The epidural abscesses are forming at the injection site for the methylprednisolone acetate steroids, which were injected into a patient’s neck or back to relieve pain, reports UPI.
The abscess represents a localized infection that affects the membranes covering the brain and spinal cord. They have formed in patients who were given powerful anti-fungal medicines to fight the meningitis outbreak and have put them back in the hospital for additional treatment. Oftentimes they require surgery.
Dr. Tom M. Chiller, deputy chief of the mycotic diseases branch of the U.S. Centers for Disease Control and Prevention, stated:
“We’re hearing about it in Michigan and other locations as well. We don’t have a good handle on how many people are coming back.”
The New York Times notes that the epidural abscess problem has just started to emerge, mostly in Michigan where 112 out of the 404 people nationwide have gotten sick. Dr. Chiller added, “We are just learning about this and trying to assess how best to manage these patients. They’re very complicated.”
Dr. Lakshmi K. Halasyamani, chief medical officer at St. Joseph Mercy Hospital in Ann Arbor, Michigan, reported that about one-third of the 53 patients treated for meningitis at his hospital have returned with the abscesses. She added:
“This is a significant shift in the presentation of this fungal infection, and quite concerning. An epidural abscess is very serious. It’s not something we expected.”
Some patients have also reported these abscesses without getting fungal meningitis. The main symptom of the abscess is severe pain near the injection site, but there are no visible signs on the skin. It takes an MRI scan to diagnose and some patients have had more than one.
In some of these cases, neurosurgeons have been able to perform surgery to drain and clean the area of infection, but some of the fungal strands and abnormal tissue have wrapped around nerves and are inoperable. In these cases doctors are giving the patients a combination of antifungal drugs and hoping they work, because they have little experience with this kind of infection.
The fungal meningitis outbreak was first acknowledged in late September and has become one of the worst public health disasters ever caused by a contaminated drug. Twenty-nine people have died so far, the majority of which passed after strokes caused by the infection. The number of cases has continued to rise.