October 7, 2013 — A second victim of last year’s fungal meningitis outbreak has relapsed after she was supposedly cured, according to The Tennesseean. The patient was admitted on October 3 and is now receiving treatment at St. Thomas West Hospital in Nashville, Tennessee.
The woman was infected at St. Thomas Outpatient Neurosurgery Center. Health department workers in the city have been working to contact other victims of the outbreak, inquire about their health, and alert them about symptoms of a relapse.
Tennessee was one of the hardest-hit states in the outbreak, with 153 reported infections and 16 deaths. Nationwide, the outbreak sickened 750 people in 20 states and caused 64 deaths.
First Fungal Meningitis Relapse Reported by NEJM
In June 2013, the New England Journal of Medicine published a case report of an 80 year-old man who was diagnosed with fungal meningitis in September 2012. He received treatment for 4 1/2 months, but relapsed in March 2013. He was treated with 4 days of anti-fungal medication and was sent home.
Researchers warn that some fungal infections require lifelong medical treatment. They stated:
“It is not known whether the current treatment guidance is sufficient. Some patients with central nervous system infection may require prolonged anti-fungal therapy owing to the chronic nature of fungal diseases.”
Fungal Meningitis Outbreak
Since September 2012, the Centers for Disease Control (CDC) has been investigating an outbreak of fungal meningitis associated with injections produced by a Massachusetts-based compounding pharmacy, New England Compounding Center (NECC).
The company distributed over 17,000 vials of an epidural steroid commonly used to treat back pain, and many vials were contaminated with the Exserohilum rostratum fungus. Before this outbreak, human infections with em>E. rostratum were very rare, and experts still do not know the best way to treat the infection.