In March of this year, the Center for Disease Control announced a multistate outbreak of fungal meningitis as a result of steroid epidural injections. Additionally, the CDC reports other patients who present with spinal or paraspinal infections such as epidural abscess, discitis, osteomyelitis of the vertebral bodies, and arachnoiditis near the site of injection. These infections have occurred in patients with and without fungal meningitis. The CDC continues to receive reports of paraspinal, spinal or meningeal infections.
This type of infection has been linked to a preservative-free methylprednisolone acetate injection from one of several lots produced by The New England Compounding Center. In March, two cases of meningitis associated with the steroid injection had been reported in Illinois.
The definition of these particular cases of meningitis infections includes any meningitis following an epidural or paraspinal injection of received after May 21, 2012. If you have developed an infection around the area of the spine, or meningitis, an infection of the spinal fluid, following a steroid injection, you may have been exposed to contaminated steroids. Infections include osteomyelitis, or infections of the bones (the vertebrae) or osteomyelitis. Inflammatory arthritis of another joint without a known cause can also be a result of infection from a local joint injection of the same contaminated steroid. The type of infection you may have had could have included a spinal facet injection, injection of the sacroiliac joint, or injection of a spinal or paraspinal nerve.
- Meningitis is characterized by headache, fever, stiff neck, and pain when looking at light. There are, of course, laboratory tests used to confirm meningitis.
- Arachnoiditis can present with tingling or numbness, and burning pain in the lower back or legs. Some people also have muscle cramps and twitches. Any infection in the area of the spinal cord can affect the bowel or bladder.
- Epidural abscess may appear as a warm and swollen area near the spine, and can impinge upon the nerves that exit at the spinal cord.. This will cause the same type of neurologic symptoms as arachnoiditis.
This is not an isolated incidence of infections as a result of contaminated steroid or other epidural injection. Epidural injections are often given to women in labor, and if sterile practices are not observed, infection is a possible. Sterile practices include vigorous hand washing, use of sterile gloves, cleaning the area around the injection site with an antiseptic wash, and draping the area around the injection site with sterile drapes.
A lumbar puncture is a procedure often performed in the emergency department for diagnosis of meningitis. Unfortunately, this procedure can also be an opportunity for introduction of bacteria into the spinal fluid if sterile precautions are not strictly observed. If you are having a lumbar puncture for any reason, be certain that despite the bustle of the emergency department, strict sterile procedures are observed.
Any physician performing a procedure that involves introduction of a needle or medication in the area of the spinal cord is aware of the danger of infection if sterile precautions are not observed. Despite all precautions, medications may be contaminated, or bacteria introduced. Know the signs and symptoms of meningitis, and if you experience any of the signs of infection around the spinal column, immediately see your physician. If you have been infected by injection of a medication into the epidural space, you may be a victim of negligence, and should consult a malpractice attorney to evaluate your damages.