Fungal Meningitis Q&A

Oct. 12, 2012 — More people have been stricken with fungal meningitis that’s been linked to contaminated steroid shots sold by a compounding pharmacy in Massachusetts.

So far, 184 people in 12 states have the rare meningitis, the CDC said on Friday. One person has an infected ankle after receiving one of the steroid shots. Fourteen people have died.

Health officials expect those numbers to rise.

Before the outbreak dominated news headlines, most people had never even heard of fungal meningitis.

WebMD reached out to experts in fungal diseases to get answers to common questions about fungal meningitis.

What is meningitis?

Meningitis involves swelling and irritation of the meninges, the membranes that cover the brain and spinal cord.

In most cases, these membranes become inflamed in response to a viral or bacterial infection. But certain drugs can also cause meningitis, as can cancer.

How is fungal meningitis different than the viral or bacterial types?

“First of all it’s very rare, so we don’t have a lot of experience with it,” says Luis Ostrosky-Zeichner, MD, an infectious disease expert and director of the laboratory of mycology research at the University of Texas Health Science Center in Houston.

In fungal meningitis, fungal organisms like mold or yeast invade the cerebral spinal fluid, the clear fluid that bathes the brain and spinal cord. They also invade the brain’s blood vessels, which can cause strokes.

“With bacterial and viral meningitis, they’re relatively common and physicians know how to recognize them,” says William Schaffner, MD, an infectious disease expert at Vanderbilt University in Nashville, Tenn. Schaffner has treated some of the patients involved in the outbreak.

Before the current outbreak, only doctors who treated people with very low immune systems, such as patients with HIV or those who were treated with immunity-suppressing medications, would see cases of fungal meningitis.

Is fungal meningitis contagious?

No. According to the CDC, the infection can’t be passed from person to person.

What are the symptoms of fungal meningitis?

They are largely the same as the symptoms of bacterial or viral meningitis: headache, fever, chills, a stiff neck, and “just feeling very badly,” Schaffner says.

But they may be slow to develop and mild.

“The speed at which people get sick is very different,” says Benjamin Park, MD, medical officer at the Mycotic Diseases Branch of the CDC.

Unlike bacterial and viral forms of meningitis, which tend to develop within hours, fungal meningitis “creeps up on you,” Park says.

“People who have gotten infected, they’ve had somewhat milder symptoms than you would expect,” says Park.

Park says nearly everyone who has gotten sick has had a headache, for example, but the headache wasn’t the worst-kind-you’ve-ever-had-in-your-life variety, as often comes with bacterial or viral meningitis.

WebMD Health

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