October 18, 2012 — The U.S. Food and Drug Administration (FDA) has linked one possible case of fungal meningitis to triamcinolone acetonide, a type of injectable steroid (corticosteroid) that is used to reduce inflammation. The product was manufactured by New England Compounding Center (NECC), a compounding pharmacy that has been linked to a nationwide outbreak of fungal meningitis and fungal infections. At least 257 people have been sickened and 20 people have died in 16 states.

New England Compounding Pharmacy (NECC) recalled all lots of all medication on October 6. On October 15, the FDA announced that they received reports of other medications (such as triamcinolone acetonide) associated with fungal infections. The FDA published this statement regarding the triamcinolone acetonide illnesses:

“One patient, identified through active surveillance, is under investigation for possible meningitis potentially associated with epidural injection of an additional NECC product, triamcinolone acetonide.  Triamcinolone acetonide is a type of steroid injectable product made by NECC. FDA-approved triamcinolone acetonide is approved for intra-articular (within a joint) or soft tissue injection.  The cases of meningitis identified to date have all been associated with methylprednisolone acetate, another similar steroid injectable product.”

Most of the people who were sickened in the outbreak received another type of steroid injection — methylprednisolone acetate. Today, investigators found spores of the Exserohilum rostratum fungus in unopened vials of the steroid shots at NECC, which have also been found in patients with fungal meningitis.

Health department officials are now scrambling to address the possibility that more than 100,000 shipments of medications from NECC could have been tainted with fungal contamination. The FDA has also issued warnings for cardioplegic solutions (used during open heart surgery) and opthalmic medications used during eye surgery.

The FDA recommends that any doctors who exposed patients to these medications should inform the patients. Patients who have had a medical procedure since May 21 and are concerned about fungal infections should contact their physician to find out if they were exposed.

Triamcinolone acetonide is a long-acting, synthetic injectable steroid. It is used to treat many conditions, including allergies, certain cancers, intestinal disorders, and more. Brand-name versions of this drug have been approved by the FDA for use during eye surgery. The drug may be administered intravenously, into a muscle, a skin lesion, or a joint.


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