Months ago, before hundreds of people became infected with a black mold fungus called Exserohilum rostratum from contaminated steroid shots, only 33 human infections had ever been reported. And those were mostly eye or skin infections in people with weak immune systems.

Exserohilium rostratum, commonly found in dirt and grasses, has never before been known to cause meningitis. Yet, floating in vials of steroid shots injected directly into the spine of people being treated for back or neck pain, the fungus can slowly grow. It sits quietly until enough accumulates for it to burrow a tiny hole, or abscess, into the lining of the spinal cord, Dr. William Schaffner of Vanderbilt University told the Associated Press.

Unlike the more common bacterial or viral forms of meningitis in which symptoms are obvious and come on quickly, fungal meningitis takes one to four weeks on average to appear. In some cases it can take longer for symptoms, such as headache, stiff neck, and nausea, to appear. They can also be very mild and still be deadly, sometimes resulting in strokes caused by the fungus invading blood vessels in the brain.

If left untreated, fungal meningitis can cause permanent neurological damage and death. However, there are drugs to treat this extremely rare condition but they are limited. Few antifungal drugs can cause side effects such as hallucinations, confusion, nausea, and liver damage.

The fungal meningitis outbreak is setting a new precedent in the medical community, and treatment is still mostly a guessing game. The latest recommendation is that the antifungal drugs be given for at least three months, but patients will still have to be monitored for side effects or a recurrence of the infection.

People who have been exposed to the fungus are advised to monitor themselves for symptoms, and some are being told to have spinal taps. Because the fungus grows so slowly, there is the risk for negative readings.

To date, the fungal meningitis outbreak has infected 328 and killed 24.

Source: PharmPro

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