Investigation of possible connection between meningitis and epidural steroid

Baltimore, MD (October 3, 2012) -- The Maryland Department of Health and Mental Hygiene (DHMH) is investigating an association between spinal injections and the development of meningitis as part of a larger multi-state investigation. At this time, DHMH has identified two cases among Maryland residents, one whom has died. No case information will be released.

This situation was first identified when a cluster of patients in a Tennessee ambulatory care clinic
developed meningitis or stroke symptoms within 1 month of receiving an epidural spinal injection with a
steroid. Aspergillus meningitis was identified in one of these patients; no organism has been identified in
the others. North Carolina has also identified a possible association between the injection of this product
and the development of meningitis, and investigations for additional cases are underway in multiple other
Although the source of these illnesses is not yet known, methylprednisolone acetate (Solumedrol) from
a single manufacturer was used for all of the affected patients, and the company has voluntarily recalled
this product.
Maryland DHMH has contacted all the facilities where implicated lots of this product were distributed to
ensure removal of the product and to facilitate notification of patients potentially exposed from July 30 to
September 28, 2012.
Facilities that have received and pulled from use the affected product are:
Berlin Interventional Pain Management, Berlin, MD
Box Hill Surgery Center, Abingdon, MD
Greenspring Surgery Center, Baltimore, MD
Harford County Ambulatory Surgery Center, Edgewood, MD
Maryland Pain Specialists, Towson, MD
SurgCenter of Bel Air, Bel Air, MD
Zion Ambulatory Center, Baltimore, MD
Symptoms of meningitis can include but are not limited to fever, headache, neck stiffness, photophobia,
nausea, or vomiting. Stroke symptoms can include but are not limited to double vision, slurred speech,
weakness on one side of the body, or difficulty walking. Patients who have received a spinal injection at
one of these facilities from July 30 to September 28, 2012 and are experiencing new symptoms consistent
with meningitis or stroke should contact their healthcare provider.
DHMH continues to work with the Centers for Disease Control and Prevention (CDC), the United States
Food and Drug Administration (FDA), and other states on the response to this outbreak.

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