October 7, 2013 — The Tennesseean has reported that an unidentified victim of last year’s fungal meningitis outbreak has relapsed unexpectedly, raising concern that other victims could be at risk.

Health department officials in Nashville have scrambled to contact other victims of the outbreak to inquire about their health and urge them to be vigilant for symptoms of a relapse. The patient was admitted to St. Thomas West Hospital on October 3, where she is now receiving treatment.

According to the Centers for Disease Control (CDC), the outbreak of fungal meningitis sickened 750 people in 20 states, including 64 people who died. The victims received contaminated epidural spinal injections that were manufactured by New England Compounding Center (NECC), a compounding pharmacy in Massachusetts. In Tennessee, most of the victims were infected at St. Thomas Outpatient Neurosurgical Center in Nashville.

NEJM Reports 1st Case of Fungal Meningitis Relapse

This is the second reported relapse associated with the meningitis outbreak. In June 2013, the New England Journal of Medicine published the case report of an 80 year-old man who was infected with fungal meningitis in September 2012. He received treatment for 4 1/2 months.

In March 2013, he visited the emergency department complaining of headache and neck pain, and he was diagnosed with relapsed fungal meningitis. After receiving 4 days of anti-fungal medication, he was sent home.

Certain fungal infections require lifelong anti-fungal therapy, but no one knows the best way to treat the fungus associated with this outbreak. Researchers warned:

“It is not known whether the current treatment guidance is sufficient. Some patients with central nervous system infection may require prolonged antifungal therapy owing to the chronic nature of fungal diseases.”

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