November 26, 2012 — The Centers for Disease Control and Prevention (CDC) has published a Health Advisory because they continue to receive new reports of fungal infections more than 7 weeks after recalling contaminated medicines from New England Compounding Pharmacy. The contaminated medicines were recalled at the end of September, and have subsequently been linked to nearly 500 illnesses and 34 deaths, mostly due to fungal meningitis. Now, the majority of new illnesses are non-meningitis spinal infections.
Some people have been diagnosed with severe, chronic spinal infections near the site of their injection that are very difficult to treat. These infections have occurred in patients with and without fungal meningitis.
The CDC has issued the following warning about non-meningitis spinal infections:
“Although cases of fungal meningitis continue to be reported, CDC has recently observed an increase in the number of patients presenting with evidence of epidural abscess, phlegmon, discitis, vertebral osteomyelitis, or arachnoiditis at or near the site of injection.”
The CDC has found that 71% of cases reported since November 4, 2012 involved non-meningitis infections such as abscesses, osteomyelitis, peripheral joint infections, or multiple conditions. They also found that the most common symptom of the infection was back pain, but this symptom may be difficult to distinguish from the patient’s baseline back pain.
The non-meningitis fungal infections found by the CDC include the following:
- Abscess: A collection of pus that causes swelling and inflammation in the surrounding tissues.
- Phlegmon: Diffuse inflammation with formation of pus, similar to an abscess but without precise boundaries.
- Discitis: Low-grade infection in the space between two vertebral discs.
- Vertebral osteomyelitis: An infection in the bone marrow inside a vertebrae.
- Arachnoiditis: Inflammation of the arachnoid, which is the membrane that surrounds and protects nerves in the spinal cord. It can cause nerves to “stick” together, which can cause chronic pain, numbness, tingling, incontinence, muscle cramps, sexual dysfunction, and even paralysis of the lower limbs
At least 12 people have also been diagnosed with peripheral joint infections, which is an infection in the joint spaces of the knee, shoulder, or ankle. People with chronic joint pain may have received contaminated steroid injections from NECC.