In recent news an outbreak of suspected fungal meningitis associated with surgical procedures performed under spinal anesthesia occurred in the United States of America (USA) and Mexico. The initial cases were 5 females with central nervous system (CNS) infection and a history of undergoing surgical procedures performed under spinal anesthesia in Mexico. Surgeries were performed in 2 private clinics in Matamoros, Tamaulipas state, on the border of the USA. A total of 547 people had procedures utilizing spinal anesthesia between January and May of 2023 at these clinics and an investigation is underway by the Centers for Disease Control and Prevention (CDC), the Mexican Ministry of Health and U.S. state and local health departments.
Currently there are 172 cases under investigation, 18 suspected cases, 10 probable cases, 6 confirmed cases, and 4 deaths. These two clinics are currently closed to patients while the investigation takes place.
Fungal meningitis develops when a fungal infection spreads from the brain or spinal cord. The infection may have originated from another site such as the lungs and is most often seen in individuals with weakened immune systems whether due to other medical conditions or certain medications. Healthcare associated fungal meningitis can occur from poor hygienic practices and poor infection control procedures during surgery or a general hospital stay and may involve direct infection of the CNS. Symptoms of fungal meningitis include fever, stiff neck, vomiting, headache, sensitivity to light and confusion. The infection can be treated with high-dose antifungal medications if suspected and diagnosed through a spinal tap to collect fluid for laboratory testing.
Patients who have elected to undergo cosmetic procedures at the clinics associated with this most recent outbreak are encouraged to visit their nearest emergency room to be evaluated even if they are not experiencing any symptoms of this deadly infection. If patients do not have access to an emergency room, they should contact their local health department or urgent care and inquire about diagnostic testing.
Maegan Traveler is an Education Specialist for Education and Institutional Preparedness for the SPECTRE Program.
Resources
https://www.cdc.gov/hai/outbreaks/meningitis-epidural-anesthesia.html#anchor_1686761273425
https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON470
https://emergency.cdc.gov/han/2023/han00491.asp
https://www.cdc.gov/hai/prevent/prevention.html
https://www.cdc.gov/meningitis/fungal.html