> FUNGAL MENINGITIS, CONTAMINATED DRUG - USA: ALERT > ************************************************* > Date: Tue, 1 Oct 2002 11:40:52 -0400 > From: John P Maher <[email protected]> > Source: North Carolina Department of Health and Human Services [edited] > > Patients being notified that injected medication may have been contaminated > -------------------------------------------------- > In the past 2 months 3 patients treated at pain clinics in North Carolina > have developed meningitis due to a contaminated batch of the drug > methylprednisolone. One died. A fourth case is under investigation. > > Methylprednisolone is a corticosteroid administered by injection to treat > joint pain [by decreasing inflammation - Mod.LL]. All 3 of the patients who > developed meningitis had received an injection of the drug in their spine > between April and July 2002. A total of 3 North Carolina facilities > received shipments of the contaminated drug: FirstHealth Moore Regional > Hospital Pain Clinic in Pinehurst, Wayne Memorial Hospital in Goldsboro, > and Johnston Pain Management in Jacksonville. (The drug supply was not used > at FH Moore Regional Hospital but was limited only to the hospital's pain > clinic.) The 3 facilities are contacting all of their patients who may have > been treated with the drug, either through spinal injection or injection > into a joint or trigger point area. > > Physicians investigating the cases traced the cause of the infections to > the drug, which was provided by a single supplier in South Carolina. The > drug was contaminated with _Wangiella dermatitidis_, a fungus. An > investigation is being conducted to determine how the drug became contaminated. > > The drug was shipped to clinics and hospitals in 5 states, including North > Carolina. The drug from that manufacturer is no longer being used; that > pharmacy has issued a recall on 17 Sep 2002 and no longer manufactures the > product. > > Patients were injected with the recalled drug as recently as 12 Sep 2002. > One of the cases developed meningitis 10 weeks after the injection, so it > is possible that new cases may subsequently develop. > > Patients who may have been infected through an injection into other parts > of their body, such as their knee or other joint, may experience symptoms > of a localized infection: pain, redness, a joint that is hot to the touch, > swelling, or difficulty with movement of the joint. Patients of any of the > 3 facilities who are experiencing any of these symptoms, or who suspect > that they may be developing an infection, should immediately contact their > primary care physician, the pain clinic where they were treated, or the > nearest hospital emergency department. > -- > [Wangiella is a dematiaceous, cosmopolitan fungus that inhabits the soil > and plant material. Wangiella may cause various infections in humans. The > only species included in the genus Wangiella is _Wangiella dermatitidis_. > The taxonomic position of this species is not fully consistent. While some > authorities classify it in the genus Wangiella as _Wangiella dermatitidis_, > others prefer to classify it in the genus Exophiala as _Exophiala > dermatitidis_. _Wangiella dermatitidis_ is an occasional causative agent of > phaeohyphomycosis. Subcutaneous phaehypomycosis is the commonest clinical > picture. The infection develops after traumatic implantation of the fungus > through the skin. _Wangiella dermatitidis_ is a neurotropic fungus. Central > nervous system infections have been reported. It may also cause keratitis, > otitis, pneumonia, and endocarditis. Disseminated infections may develop > particularly in immunocompromised patients. _Wangiella dermatitidis_ may > cause bovine abortion and still birth. - Mod.TG > > _Wangiella dermatitidis_ has been associated with various human infections, > usually related to traumatic or iatrogenic wounds. Infections have been > associated with such risks as peritoneal dialysis, intravenous catheters, > and keratoplasty. The source of the contamination in this incident is as > yet unknown. The cases of meningitis reported, given the delayed onset, > were probably related to spread to the subarachnoid space from a > parameningeal occult infection with the organism. - Mod.LL] -- The silver-list is a moderated forum for discussion of colloidal silver. Instructions for unsubscribing may be found at: http://silverlist.org To post, address your message to: [email protected] Silver-list archive: http://escribe.com/health/thesilverlist/index.html List maintainer: Mike Devour <[email protected]>
