The Centers for Disease Control and Prevention (CDC) is recommending that health care professionals consider obtaining an MRI with contrast of the injection site in patients who received steroid shots from recalled lots tied to the deadly multistate fungal meningitis outbreak who also have persistent pain – even if it is consistent with pain they were experiencing before receiving the shots. The reason, the CDC said in a health alert issued this week, is that the patient may be suffering from spinal or paraspinal infections that are subtle and difficult to distinguish from the patient’s baseline chronic pain.
The recommendation is based on a review from diagnostic imaging of patients exposed to contaminated steroid shots injected into the spine to treat back or neck pain or into joints such as the ankle or elbow to treat joint pain. Preliminary data showed that among patients with no previous evidence of infection, and with new or worsening symptoms at or near the site of their injection, more than 50 percent of patients had symptoms suggestive of localized spinal or paraspinal infection, including epidural abscess, phlegmon, arachnoiditis, discitis or vertebral osteomyelitis.
The new information suggests that some of the 14,000 people who were exposed to the fungus through the tainted injections may currently have an unrecognized, localized spinal or paraspinal infection.
As of Dec. 18, 2012, 620 people have developed fungal infections after receiving the injections, and 39 have died. Within the past two reporting periods since Dec. 3, 2012, 80 new cases of infection have been reported to the CDC, most of which are spinal or paraspinal infections.
Source: Infection Control Today