Multistate fungal meningitis outbreak - interim guidance for treatment
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Multistate fungal meningitis outbreak - interim guidance for treatment

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      MMWR. Morbidity and mortality weekly report 2012 Oct 19;61(41):842.

      CDC and the Food and Drug Administration (FDA) continue to work closely with state and local public health departments on the multistate meningitis outbreak investiga¬tion of fungal infections among patients who received a steroid injection of a potentially contaminated product into the spinal area. The investigation also includes possible fungal infections associated with injections in a peripheral joint space. These cases are associated with a potentially contaminated steroid medication prepared by New England Compounding Center (NECC) in Framingham, Massachusetts. Fungal meningitis pathogens that have been found in the investigation include Exserohilum and Aspergillus. Exserohilum rostratum (a brown-black mold) is the predominant pathogen in this outbreak, and expert opinion and published literature indicate that voriconazole might be effective in treating infec¬tions caused by brown-black molds and infections caused by Aspergillus species. CDC interim guidance for treatment of adult patients with central nervous system and/or parame¬ningeal infections associated with injections of potentially contaminated steroid products from NECC and CDC interim guidance for treatment of adult patients with septic arthritis associated with intra-articular injections with potentially con¬taminated steroid products from NECC recommend empiric antifungal therapy. Additional information is available at hai/outbreaks/clinicians/guidance_cns.html and http://www.

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