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Centers for Disease Control and Prevention
Exserohilum, a type of black mold, has killed most of the victims in an outbreak of fungal meningitis.
She had a history of pain, the 51-year-old woman who showed up at a Maryland emergency room with a headache so bad it made her face hurt. Within 10 days she was dead, one of the first victims of an outbreak of fungal meningitis that has killed at least 20 people and made nearly 260 sick.
The case is the first to be described in medical detail, and shows that doctors need to act quickly if someone shows up with symptoms after having been given an injection that may have been contaminated with fungus.
She’d been treated for neck pain and a chronic condition called fibromyalgia that is defined by aches and pains all over the body and general weakness and fatigue. She had decided to try a new treatment, an injection in her neck of a steroid to help stop the pain there. It works in some patients – studies show it provides relief about half the time.
It should have been an in-and-out procedure. The steroid injections are considered very safe. The woman had no risk factors, Dr. Jennifer Lyons of the Howard Hughes Medical Institute and Johns Hopkins University in Baltimore reported. “She had not received injections previously, had no history of immune compromise or trauma, and was not taking any long-term medications,” they wrote in the report published in the Annals of Internal Medicine.
A week later, she developed the severe headache – so bad it drove her to the ER. Now, of course, doctors know that anyone who has had a steroid injection and shows up with symptoms like a severe headache should be checked for infection. But this woman was one of the first affected, before word got out.
Headaches are a common side-effect of any injection to the spinal cord. The ER staff did a CT scan to make sure she wasn’t having a stroke or perhaps suffering from a brain tumor and she was sent home.
But she was back the next day, suffering from double vision and nausea. She was dizzy and off-balance – all classic symptoms of meningitis. But she didn’t have a fever and her blood looked normal: no evidence of the immune system reaction seen when meningitis is caused by bacteria or viruses. An MRI didn’t show anything amiss.
All this time, the fungus must have been spreading through the patient’s brain and spine. (She hasn’t been identified in the report to protect her privacy and that of her family). State and federal investigators have found three different types of mold in samples of steroid taken from the New England Compounding Center in Massachusetts and from spinal fluid taken from some of the victims.
The meningitis outbreak tied to steroid epidurals has killed five people so far, and originated from a specialty pharmacy in Massachusetts. NBC's Brian Williams reports.
Fungal meningitis is rare, and most of the cases have been caused by a mold called Exhiloserum that had never been known to cause meningitis before. Doctors have reported that the mold seems to grow very slowly and cause very subtle symptoms at first.
The Centers for Disease Control and Prevention believes that quick treatment will help, and with the Food and Drug Administration has put out a call for doctors to proactively check with patients who have been treated with any product from NECC – especially injections.
In the case of the 51-year-old woman, the steroid injection mainlined mold right into the fluid that bathes the brain and the spine.
Her doctors didn’t suspect this, although they did an MRI and checked for viruses or bacteria. As she deteriorated, losing her ability to speak and breathe on her own, they dosed her with antivirals and antibiotics, as well as steroids. When they first checked her spinal fluid, it didn’t look that bad. Now doctors know that even small signs of inflammation might mean a patient is infected with these particular molds, and they should start immediate treatment with antifungals.
When she continued to worsen, mystified doctors transferred the patient to Johns Hopkins, where Lyons and a large team of colleagues took over.
There tested her for herpes, shingles, Epstein-Barr virus, West Nile and another virus called cytomegalovirus. They even checked for fungus – a type of yeast called cryptococcus and one called histoplasma that is found in animal droppings and that can cause an alarming type of pneumonia. Negative. It would not have occurred to them to test for a black mold more commonly known for infecting grains, and the tests probably would not have shown it, anyway.
By now the infection was showing up in her brain, and there was swelling at the place on her neck where she had been injected. By the ninth day she was in a coma and they started an antifungal drug, liposomal amphotericin B. But she was brain-dead the next day. Finally, tests revealed the Exserohilum black mold that had killed her.
An autopsy showed it had ravaged her brainstem and eaten into blood vessels and her spinal cord.
Related news:
- This isn't the first fungal mengitis outbreak
- Four more die in fungal meningitis outbreak
- Regulators say they had no clear powers to stop pharmacy
Leave a Comment:
This article reads like an episode of "House."
That's exactly what I was going to say. Also, the fact that her story almost brought me to tears. You read about bad stuff happening all the time, but this story hit me more than most. I cannot even fathom the last week or so of her life. You get an injection to help ease pain in your body, and end up living through hell before taking your last breath. I am so sorry this woman had to endure this torture. At the very least, it looks like from her death others may survive due to her circumstances and example.
And yes, I just know without a doubt, that Dr. Gregory House would have solved this case!
It's a horrifying account to be sure. It did remind me of an episode of House, only without the happy ending.
This is tragic, but I hope the doctors now update their diagnosis and treatment protocols to learn from such incidents.
AB-1981-
You can count on the whole medical field updating their data system to keep on top of this new disease's profile. Usually, (unless at a specialty)a General or teaching/private hospital, sees a wide range of injuries, illnesses and diseases which will fall into various groups, repeatedly. But for the most part, nothing really exotic is seen.So when a disease like this arrives in the ER, it can slip through the cracks. After all, a severe headache is practically the number one reason people come to the ER on their own.
When tests don't reveal any obvious condition, sending the patient home with instructions to return if things get worse, is normal, with some pain med. It would cost a small fortune,waste resources and manpower testing for every disease if doctors did this for each person who came in complaining about a headache. Especially when prior evidence has shown most headaches go away on their own with no lasting damage or effects.
I can appreciate how this woman might have felt because of severe headaches I get from a car crash that sometimes must be treated at the ER. Others frustration and desire to get some help. I can also appreciate how the doctors may have felt, at not being able to relieve her suffering, nor finding out what was causing the problems she was having. To enter this profession and then faced with a demon disease that leaves you impotent and without any means of helping someone who is suffering horribly.
Compassionate people with deep hearts, feeling totally helpless usually take the deaths of those they are treating very personal. Though this woman was one of the first, her death was not senseless, for she helped make possible the means of recognizing quickly those infected so they could get treatment fast. May she be at peace, surrounded by all her loved ones who have gone on before her.
Someone comes to the ER in terrible pain and she's sent home? I hope there's a lawsuit pending. This poor woman could probably have been saved if the doctors had done their jobs instead of what likely happened - they bowed to the insurance companies, did all they 'could' do - couldn't charge for anything else and sent her home.
Looks like doctors did everything possible. A doctor is not a all seeing god able to deduce every and any illness at the blink of an eye. They did their jobs. This is not like a plumber seeing a leak and fixing it.
Why are you even bringing insurance companies into this? The lawsuit should be against the drug manufacturer...like Rweber said, they did the appropriate diagnostics. Sometimes when a patient presents the symptoms are not definitive for one particular diagnosis.
a doctor never knows what is wrong, never! all they do is guess, try a pill, and then guess again, try a pill...
there is nothing other than continuous experimenting
JC, that happens every day in ERs across the country. Keep your fingers crossed that something unusual doesn't happen to you. I know I will.
my mom was a nurse, my sister an EMT, and i have worked in life and health insurance, both private and public sector. i think you are really misunderstanding science and healthcare.
you don't come with an owners manual. you are not a car. there are MANY diseases still unknown to medical science, there are many more that have the exact same symptoms.
you think a headache means she should have been kept in the hospital? do you know how many headaches people have? do you have any idea how many of them are just migraines?
there is a saying in medicine: when you hear hoof-beats, think horses, not zebras. it means, when you see symptoms, you have to think what are the most common conditions linked to those symptoms. at least 90% of the time you will be right. extremely rare things like this are just NOT on the radar.
i also guess you don't go to the hospital much. the ER is an EMERGENCY Room. if you are stable, you are no longer an emergency. you are released to the care of your PCP. if you get worse, you are told to come back. most often, people do not have to come back. again, law of averages - vast majority of cases do not need to come back. they had NO reason on earth to suspect that she had what she did. the first few cases of EVERY outbreak known to man, the people die because it is unexpected. please, learn the history of disease before you make sweeping statements about how the hospital should have handled her.
my mom was a well-respected nurse; she was even a charge nurse over nurses with higher degrees than hers. but when she became terminally ill, it started with kidney failure, and she didn't know the signs of kidney failure. well, she knew them to SEE them, but not to experience them. it took her by surprise. and that is someone with a wealth of medical knowledge and experience, especially with patients with chronic illnesses that includes kidney failure.
just because someone knows about things does not mean they suspect them. the rarity of this is so ridiculous, i don't know how anyone can say with a straight face that the doctors failed this woman. doctors wrack their brains trying to figure out what is wrong. there is a show that used to be on Discovery Health called Mystery ER or something, and it showed real doctors, in real situations like this, where they are against the clock to figure out why the patient isn't responding, or why they are experiencing what they are. it was a real eye opener. these doctors will work for days on 3, 4 hours of sleep, in the medical library all day and night trying to make sense of what they see. i really, really, really can't comprehend how people do not understand that there is so much that can go wrong with a human body, and how hard it is to diagnose something you NEVER see.
And these are all the reasons that we "practice" medicine.....not because of insurance companies, or lack of want to save....and yes, a bit of each of us dies too when we lose a patient. Many thanks to all who have spoken to this.
So it sounds like if you actually live through this rare fungal meningitis, you are still going to be in very sad shape and not be the same person you were. They use the word “ravaged” as a description to what it did to her brain and spin. I feel so very sorry for these people.
JC12 - what a response - first thing - hope there is a lawsuit.
"Fungal meningitis is rare, and most of the cases have been caused by a mold called Exhiloserum that had never been known to cause meningitis before"
Up until this outbreak there wasn't a reason to check for fungal meningitis whether or not the insurance company had anything to do with it. Not that I'm saying that doctors are without recourse but there are times they do everything within their power to save the patient and they just don't succeed. It's easy to sit there in your chair and second guess someone after the fact when you have all data they didn't have at that time, but I'm sure there was much frustration on their part not being able to diagnose what was the root of the problem.
this isn't the first fungal meningitis, just the first from this mold...
they should have watched more carefully her progressive condition, her blood vessels just didn't do that after she died
especially if you do it from a story on the internet.
This company and all its employees should never be licensed again in any state in the U.S. and the owners should be banned from ever running another compounding pharmacy or even a street side lemonaide stand! This is ridiculously inept and fatally gross negligence. There should be fines and possible jail time for those directly responsible. People are dying...
tracontech~~I hear you. I would also like to know why the FDA and CDC let this slip through the cracks. Maybe budget cuts? Maybe plain and simple negligence? Did the congress not pass a law, with limitations on how much a patient can sue a medical facility and/or administrator? I have heard that NECC is owned by, you guessed it, CHINA. Corrupt politicians and corrupt corporations are consuming our country with their selfish greed.
If Romney is elected he will pursue the deregulation of all government agencies. This will happen again, and again.
If Romney were already in office, you would say this is his fault. But he's not, so you use a scare tactic by using an example of something that happened under Obama to tie to Romney. So if something like this would be Romney's fault later, is it Obama's fault now?
I think either is a stupid charge, but consider everything you're saying when you make a comment.
Dear gods. A woman and a dozen others are dead and you want to spout political tripe? Are you retarded?
Rweber-1968632
This tragedy has nothing whatsoever to do with politics-it wouldn't matter if Atilla the Hun was running for president,or Genghis Khan was president-
You are a part of the problem in this country-just take a tragic outbreak of a disease,and immediately tie it to one political party,or member of a party-
Get a life-get outside-do something other than watch far left TV shows,listen to far-left radio shops,and read all the BS from the plethora of far-left websites.
Do something useful-be a part of the solution-not a part of the problem-or just shut the @!$%# up,don't type such assinine comments.
But this is political! The FDA did not have enough power to stop the pharmacy. I would thank anyone to pay attention to what is happening in politics.
larry1959#7.3 Pot meet kettle?? Your rant was much more politically, partisan than was Rweber-1968632. You should know that Romney and the republican party, are all about de-regulation, and de-regulation has caused/allowed most of this nations' economic, social and cultural problems.
and they say we shouldn't test monkeys first.....
You don't understand the word "contaminated".
They don't test contaminated meds at all. You can look it up.
i feel like someone should say this and it might as well be me, this sounds like the precursor to the zombie apocalypse. just saying.
This is really sad, what a horrible horrible way to die.
Tragic story.. But on another note, don't they teach grammar and composition at J-school anymore???
"First case history shows fungal meningitis can destroy brain fast"... No - "Can destroy brain QUICKLY"
Really? You are going to question the authors use of fast instead of quickly?
Here's a news flash for you-in most cases-the two words are interchangeable.
In this case-either word is an adequate description of what happened.
Maybe you went to the wrong "J-school" or had @!$%#ty teachers,or you slept through the class on synonyms -
Synonyms are words with identical or similar meanings. Words that are synonyms are said to be synonymous, and the state of being a synonym is called synonymy. The word comes from Ancient Greek syn (σύν) ("with") and onoma (ὄνομα) ("name"). The words car and automobile are synonyms. Similarly, if we talk about a long time or an extended time, long and extended become synonyms.
From wikipedia
I agree with Mark, incorrect usage of language denotes a lack of education, even though words may be synonyms, that does not follow that their usage are also similar, it is the dumbing down of the populace that is helping to contribute to a myriad of problems that the US in general is facing. Situations such as those described with this lady and her family that she is leaving behind, will only become more commonplace as people lose their ability to think, speak and write.
I want to know who is responsible not what it can do.
What a horrible sounding death. Sounds almost as bad as Ebola.....
What patients need to ask doctors before receiving any steroid injections like this again is where they get their injections from? If they are from a compound lab, find another solution for your pain. This is just another reason why marjuana should be legalized. People can use it for pain relief with a prescription from a licensed seller. I have never been one to try pot or want to live in California, but after reading what happened to these people, as I get older I may have to reconsider such a state with legal pot. Why do people not use alternative medicines for pain, because the one side of politics wants to control the drug industry for profits. I would be willing to bet that this would not even be an issue in Canada or Europe where there is socialized medicine. The for profit medicine in this country stinks to high heaven. Everyday drug companies, hospitals, doctors, and drug companies put profits above the people. This is just another that Obama needs to take control of with a second term. There MUST be oversight and regulation of the compounding pharmacies. To not have regulations is playing Russian roulette with your life, your spouse, your child, your grandchild. These deaths were completely preventable which means without a doubt there is negligence involved. The negligence is with the compounding pharmacy and our own government officals who continually vote for no regulations or deregulations. Yes, our own politicans are literally killing us with these types of decisions or inactions. It is time to vote complete Democrat for President, House, and Senate this election for our future to get changes made that are literally common sense.
So now, I have had so many injections in the last 7 years of my back problems, is this why I have massive head aches, constant leg pains and spinal rotting bones..Hmmm, could I get lucky enough to die from this same @!$%# since the doctors today don't give a dam about trying to fix anyone today. Just 7 years and $250.000 dollars later and nothing fixed. They wanted to give me more shots this last month and I finally said screw you, Do you got a purpose. a plan for an out come. their only outcome is to fill their bank account again and it's sad that people pay for their greedy intentions and doctors walk away rich for doing nothing. Now giving people viruses, What a joke this whole countries medical maul practice has become, insurance fraud constantly while the patents like me get worse each day we live. OH but fill us up with more drugs and keep us alive until you can suck us dry, suck our families dry of any inheritance.. Bunch of crooks deserve to be sued, Big time, I hope my family gets their chance after my death and in this corrupt greedy society, it couldn't be soon enough
I hear you chuck. It is truly ridilicous. I have had several issues with no luck on getting anything truly fixed. I have severe TMJD which is not even covered by insurance and is claimed not to be curable. TMJD may not sound bad but cases of severity vary greatly. Some may have some minor problems from it but others can have neck, jaw, facial pain, unalignment issues and many other issues just from it. However TMJD is treatable and technically cureable although you have to do tons of researcdh to figure this out and docotors are misinformed and know very little if anything on the condition. Most dentists are not even worthwhile for it as they are not to knowledable in the area. However there are some that have studied and went through certain training and etc to recognize and treat it properly.
I also have had my gallbladder out and have what is being caled PCS from it. I was not aware of the condition or made aware it was a condition possible after the surgery. All it seems to be about is money, money, money for medical fields for the most part. A lot of doctors don't even listen, argue, play GOD and then do little testing and send you home even though you know there is something wrong. It is truly sad to see.
Did you ASK what the side effects of surgery could be from gall bladder removal? Doctors don't have time to treat us like children. You have to advocate for and educate yourself.
That said, you are right that trying to get good care is beyond frustrating. Insurance companies make it even worse.
With such a severe first of its kind headache, I'm sure any intern would know to examine the spinal fluid. Would fungus show up on a smear, or a stained specimen? That's how they finally found it. It looks like a plant growing in the body already!
Doctors don't do spinal taps at the drop of a hat. They can CAUSE nerve damage, chronic headaches, etc. Quite a few of those who were tested later had clear spinal fluid but had meningitis. Hind sight is always 20/20. Seems they did run a lot of tests searching for an answer. I feel bad for this woman's family, but the fault clearing lies with the pharmacy for making her sick to start with.
Vitamin C in high doses in IV anyone? Please do the search for high doses vitamin to cure many problems
i can not believe that no one is paying attention
i do not see any of my postings; I am not sure why but mega doses of vitamin C can do miracles
just like NZ farmer got helped with vitamin C mega dozes and you can see it on youtube NZ farmer 60 min program; search for it on youtube or Dr Levy website has it
hope this one goes trough since this is being censored
well high doses of vitamin C are very effective
in go to youtube and search for NZ 60 min farmer miracle and you will learn how effective is
Vitamin C is not effective for molds.
Poor woman. You would think they would keep running tests until they found a culprit. Condolences to her family and friends.
I hope this brings about change at the compounding factories.
My sister died from the same thing but back in May of this year and It took them along time to determing what was wrong but by the time they did it have attacked her brain to the point that there was nothing that they could do and she died within two days of them finding out So i can sympathize them with what going on withe the families of these victims, she went in complaining of pain and they could not detemine what was causing the pain until it was too late,
yes this virus out break is something can happen any time
This isn't a virus, it's a fungus. Know your biology before you open your mouth.
sorry to hear about the losses of loved once but if you go to youtube and look at the segment from NZ tv 60min farmer miracle you will know how powerful vitamin C in iv high doses is; the lives could have been saved
Dr. Klenner is one of the pioneers in vitamin C. Dr carthcat another one
medical doctors are kept in dark and believe that vitamin C is a joke cure since they try to discredit it all over the news with studies with doses which are so low that nothing will happen; but as in video where family insisted on the high dose vitamin C we can make a change if we would be informed on that option; doctors in that case did not believe in it as well and were doing first just because they wanted to look good but then the establishment realized what is going and so tried to stop it but as you will see it got too far to stop that case to be seen by the world; people need to be a bit open minded about it and especially doctors; and not to mention of vitamin C in high doses to reverse CVD(cardio vascular disease) that is another story #HEART
it did not let me to post any links but i try to put them in different form
vitamincfoundation org is one to go and do some search
orthomed dot com is another page with some good info dr. Carthcat had treated about 9000 patients with vitamin C; you talk to other doctors about it and they will ridicule and dismiss something like that
This happens a lot in the ER. The patient can appear very ill, they take your blood and they don't see anything wrong. They will patch you up and send you home. Medicine 101, if the patient appears very ill and nothing shows up in the blood Tap the patient. Doctors don't go far enough. I experienced this with my husband. After three trips to the local ER I finally got him to a major hospital and guess what, he was suffering from encephalitis for four weeks. They Tapped him immediately and found it.
All people should get the LOT numbers of any medications given to them, whether oral, topical, injectable: IM or IV. To include any contrast agents, for MRI- uses metal gadolinium or CT scan which uses many radionuclides. You should also know what ionizing radiation does to you with 1 scan.
double strand DNA breaks 67% within 1 mS.
Infections can be worsened by radiation exams. Pseudomonas, Aspergillus F. , Klebsiella, Enterococcal , yes you can be made worse with xrays and CT scans and contrasts. A simple blood test for IgE and CBC, and blood cultures will grow out this deadly mold and other bacteria, no need to wait for it to multiply in the body. This type of death is extremely painful, physically and emotionally and still can be prevented in those who received injections.