As public health officials continue to plead with people who may have been exposed to fungal meningitis at two cosmetic clinics in Mexico to get tested, doctors in a small Texas county are noticing a peculiar complication: some patients who appear be recovering with treatment suddenly sicker
Seven people have died from the fungal meningitis outbreak associated with the two surgery clinics in Mexico, according to the Centers for Disease Control and Prevention.
The outbreak of fungal meningitis associated with surgical procedures using epidural anesthesia has infected nearly three dozen people and killed seven so far. according to the latest numbers from the CDC. It is not clear how many patients are hospitalized across the country. Most of the patients are young women from 23 US states who came to the clinics for cosmetic surgery procedures between January 1 and May 1.
However, most of those exposed are from Texas.
“We are still getting people who have not been tested, but the vast majority have been notified,” said Dr. Iván Meléndez, the public health authority for Hidalgo County in Texas. “Less than half have been tested” – a lumbar puncture to look for signs of meningitis.
Meléndez and other health officials are concerned that people who have been exposed are not taking the risk seriously.
The symptoms of fungal meningitis, unlike bacterial or viral meningitis, often take weeks or longer to appear. Some fungal infections can take up to a year to show symptoms. The CDC declined to give a specific date by which people could be sure they are no longer at risk.
In Cameron County, in South Texas, where three of the seven deaths were reported, only half of the 54 identified patients received the lumbar puncture, said Dr. James Castillo, the county health authority.
The current outbreak is believed to be caused by a relatively rare organism, fusarium yesOlani, which has been isolated from only a few patients so far. This is the same fungus responsible for an outbreak of fungal meningitis in Durango, Mexicolast November it killed almost half of those infected.
Surprising complication of fungal meningitis
Dr. José Campo Maldonado, an infectious disease specialist at Valley Baptist Medical Center in Harlingen, Texas, noted that infected patients have problems with the blood vessels in the brain.
“Virtually every patient we’ve seen at the hospital has some type of neurovascular complication,” he said. These include problems such as spasm of the arteries in the brain or an infection of the blood vessel walls themselves, known as a fungal aneurysm, she added.
All of the patients at Valley Baptist Medical Center were recently evaluated after some patients appeared to be doing well on treatment but suddenly became worse, Castillo said.
“It looks like a stroke where they can suddenly go unconscious,” said Castillo, who is surprised at the number of patients who are having this problem. “For some reason, aneurysms and spasms occur around the brain stem, but no one knows why it happens.”
Blood vessel problems are not exclusive to fungal meningitis and can occur with the more common ones as well. bacterial meningitis.
One possible explanation, Campo Maldonado said, is that the fusarium yesOlani The body has a special taste for the blood vessels of the brain. However, more testing would be required to say for sure.
Unfortunately, this situation is familiar to CDC scientists who, in a call last week with Campo Maldonado, described similar findings in a fungus meningitis outbreak in Durango, Mexicowhich killed almost half of those infected.
“This makes the situation for some of the patients who are hospitalized right now very complex because we are seeing a high prevalence of those same problems,” he said.
As a result, some patients have been left with permanent vision loss and hydrocephalus, a condition in which there is too much fluid in the brain.
Since treatment involves three to six months of antifungal therapy, it’s too soon to know the full prognosis for patients who come for treatment, Campo Maldonado said.
What makes recovery more challenging, he said, is the myriad of side effects associated with the drugs used for treatment, including hallucinations and kidney and liver problems.
Nearly 40% of the confirmed cases in Cameron County have died, and none of the nearly dozen confirmed cases in hospitals have been discharged due to complications, Campo Maldonado said.
The three confirmed cases in Hidalgo County are recovering at home and will continue to receive treatment for some time, Melendez said.
