Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New insight on managing fungal meningitis outbreak

24.10.2012
University of Michigan Health System physician authors New England Journal of Medicine report on best options for safe, effective patient treatment

As the number of fungal meningitis cases continues to rise, physicians across the country are faced with how best to provide the early treatment that can save lives.

A University of Michigan Health System infectious disease expert is the lead author of a New England Journal of Medicine report detailing how the outbreak evolved and the complexities of providing anti-fungal treatments.

Carol F. Kauffman, M.D., has served as an advisor to the Centers for Disease Control and Prevention as it investigates the more than 200 cases of fungal meningitis linked to a contaminated steroid injected in patients for pain relief. A large number of patients in the outbreak are older adults, many of whom have substantial coexisting illnesses that make care decisions challenging.

None of the contaminated medicines were administered by the University of Michigan Hospitals and Health Centers.

Kauffman, a former board member of the Infectious Diseases Society of America, has focused her research career on diagnosis and treatment of fungal infections, especially in immunocompromised hosts, and prevention and treatment of infections in older adults.

“Treatment recommendations will certainly evolve as clinicians gain more experience with managing these infections,” says Kauffman, chief of infectious diseases at the VA Ann Arbor Healthcare System and professor of internal medicine at the University of Michigan Health System.

“Given the (lack) of data pertaining to treatment and the complexity of management, decisions about the treatment of patients with proven or suspected infection should be made with the input of an infectious diseases specialist,” she says.

Patients found to be infected are being treated with a fairly high dose of voriconazole, which can cause side effects including visual disturbances, confusion, hallucinations, nausea, and liver test abnormalities.

“There is appropriate concern about the toxicity of voriconazole, particularly at the doses recommended to treat meningitis,” Kauffman says. “Visual hallucinations have been especially problematic in patients treated in this outbreak and appear to be related to high serum levels. Decreasing the dose of the drug will obviate this effect.”

There are also significant drug-drug interactions. Administering voriconazole to patients who are already taking agents such as blood thinners, statins, benzodiazepines, and certain seizure medicines, to name just a few, should be done with care, Kauffman and others advise. Doctors should play close attention to decreasing the doses of other medicines and monitoring blood levels.

The CDC reports the death toll has risen to 20 people with 254 fungal meningitis cases confirmed in 16 states, including Michigan. Infections have only been found in patients injected with methylprednisolone acetate from the New England Compounding Center, which has been recalled.

The CDC advises patients who feel ill and are concerned they were injected with recalled products to contact their physicians. Doctors should be aware of symptoms of fungal meningitis and seek rapid diagnosis and treatment to prevent serious complications and deaths.

Typically in this outbreak, symptoms – such as headache, fever, nausea, and neck stiffness -- have appeared one to four weeks following injection. But fungal infections can be slow to develop and patients should be vigilant about onset of symptoms for up to two months.

Reference: “Fungal Infections associated with methylprednisolone injections – Preliminary Report,” Carol A. Kauffman, M.D., Peter G. Pappas, M.D., and Thomas F. Patterson, M.D. New England Journal of Medicine. Oct, 19, 2012DOI: 10.1056/NEJMra1212617.

Shantell M. Kirkendoll | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht Finnish research group discovers a new immune system regulator
23.02.2018 | University of Turku

nachricht Minimising risks of transplants
22.02.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Attoseconds break into atomic interior

A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.

In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...

Im Focus: Good vibrations feel the force

A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.

By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Basque researchers turn light upside down

23.02.2018 | Physics and Astronomy

Finnish research group discovers a new immune system regulator

23.02.2018 | Health and Medicine

Attoseconds break into atomic interior

23.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>