Issuance of guidance on management of asymptomatic patients who received epidural or paraspinal injections with contaminated steroid products
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Issuance of guidance on management of asymptomatic patients who received epidural or paraspinal injections with contaminated steroid products

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      October 23, 2012, 22:00 ET (10:00 PM ET)

      CDCHAN-00330-2012-23-04-UPD-N

      Issuance of guidance on management of asymptomatic patients who received epidural or paraspinal injections with contaminated steroid products As part of its ongoing investigation of the multistate outbreak of fungal infections, the Centers for Disease Control and Prevention (CDC) continues to assess and revise interim guidance to clinicians involved in the management of patients who received injections with contaminated steroid products distributed by the New England Compounding Center (NECC). Since early in the outbreak, CDC has recommended against antifungal prophylactic or presumptive treatment of exposed asymptomatic patients in the absence of diagnostic testing with results indicating meningitis. This recommendation remains unchanged.

      Nevertheless, CDC recognizes the need to assist clinicians in managing asymptomatic patients who received epidural or paraspinal injections with contaminated steroid products.1 CDC is releasing updated interim guidance to clinicians based on new data that has become available during this investigation.

      CDC analysis suggests that the period of greatest risk for development of fungal meningitis among patients who received epidural or paraspinal injections with contaminated products1 is during the first 6 weeks (42 days) after injection; therefore, additional monitoring of these patients should be considered. Accordingly, CDC provides guidance for asymptomatic patients who received epidural or paraspinal injections with contaminated steroid product within the last 6 weeks (42 days), and those who received such products longer than 6 weeks (42 days) ago. For specific details about the updated guidance, see Guidance on Management of Asymptomatic Patients Who Received Epidural or Paraspinal Injections with Contaminated Steroid Products (http://www.cdc.gov/hai/outbreaks/clinicians/

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