Meningitis Cases Are Linked to Steroid Injections

The following is an excerpt from an article in:


The New York Times
Wednesday, October 03, 2012

Meningitis Cases Are Linked to Steroid Injections

By DENISE GRADY

Dr. April Pettit, an infectious diseases specialist at Vanderbilt University, was worried about her patient. He had been ill with meningitis for two weeks, he was not getting better, and she could not figure out why. Antibiotics, the usual treatment, were not helping. Bacteria, the usual suspects, could not be found.

On the morning of Sept. 18, as she and a colleague were examining the patient and talking to his family, a pager buzzed. It was the hospital lab, with an answer at last — but a troubling one.

A culture of the patient’s spinal fluid had revealed a fungus, Aspergillus. The patient was so ill that he could no longer communicate, so Dr. Pettit spoke to the family.

“I told them it was a very unusual cause of meningitis in healthy people, and that we needed to try to figure out how he got this infection,” she said.

Had he done anything unusual in the weeks before he became ill? she asked. The answer alarmed her. He had had a steroid injection in his spinal area to relieve back pain — a common treatment, administered to millions of people in the United States every year.

Dr. Pettit called the State Health Department.

She is now credited with being the clinician who recognized the “index case” in what has become a frightening outbreak of meningitis that has killed two people and sickened 12 others who also received steroid injections in their spines for pain. Doctors suspect that the steroid medicine was contaminated with the fungus. The meningitis does not spread from person to person.

Officials said it was not possible to predict the extent of the outbreak yet. Thirteen of the patients have been in Tennessee, and one in North Carolina. Two of the cases were new as of Tuesday, and health officials have said that there could be more cases and that other states could be affected.

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