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Long-term Outcomes of Patients With Fungal Infections Associated With Contaminated Methylprednisolone Injections.
- Source :
-
Open Forum Infectious Diseases . Jun2020, Vol. 7 Issue 6, p1-10. 10p. - Publication Year :
- 2020
-
Abstract
- Background The largest health care–associated infection outbreak in the United States occurred during 2012–2013. Following injection of contaminated methylprednisolone, 753 patients developed infection with a dematiaceous mold, Exserohilum rostratum. The long-term outcomes of these infections have not been described. Methods This retrospective cohort study of 440 of a total of 753 patients with proven or probable Exserohilum infection evaluated clinical and radiographic findings, antifungal therapy and associated adverse effects, and outcomes at 6 weeks, 3, 6, 9, and 12 months after diagnosis. Patients were grouped into 4 disease categories: meningitis with/without stroke, spinal or paraspinal infections, meningitis/stroke plus spinal/paraspinal infections, and osteoarticular infections. Results Among the 440 patients, 223 (51%) had spinal/paraspinal infection, 82 (19%) meningitis/stroke, 123 (28%) both, and 12 (3%) osteoarticular infection. Of 82 patients with meningitis/stroke, 18 (22%) died; among those surviving, 87% were cured at 12 months. Only 7 (3%) of 223 patients with spinal/paraspinal infection died, but at 12 months, 68% had persistent or worsening pain and only 47% were cured. For the 123 patients with both meningitis/stroke and spinal/paraspinal infection, 10 (8%) died, pain persisted in 72%, and 52% were cured at 12 months. Only 37% of those with osteoarticular infection were cured at 12 months. Adverse events from antifungal therapy were noted at 6 weeks in 71% of patients on voriconazole and 81% on amphotericin B. Conclusions Fungal infections related to contaminated methylprednisolone injections culminated in death in 8% of patients. Persistent pain and disability were seen at 12 months in most patients with spinal/paraspinal infections. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MYCOSES
*CROSS infection
*METHYLPREDNISOLONE
*FUNGEMIA
*CHRONIC pain
Subjects
Details
- Language :
- English
- ISSN :
- 23288957
- Volume :
- 7
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Open Forum Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 144824558
- Full Text :
- https://doi.org/10.1093/ofid/ofaa164