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 Microgel powder fights infection and helps wounds heal
14.11.2018 | Michigan Technological University

nachricht Spread of deadly eye cancer halted in cells and animals
13.11.2018 | Johns Hopkins Medicine

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: UNH scientists help provide first-ever views of elusive energy explosion

Researchers at the University of New Hampshire have captured a difficult-to-view singular event involving "magnetic reconnection"--the process by which sparse particles and energy around Earth collide producing a quick but mighty explosion--in the Earth's magnetotail, the magnetic environment that trails behind the planet.

Magnetic reconnection has remained a bit of a mystery to scientists. They know it exists and have documented the effects that the energy explosions can...

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

Im Focus: Penn engineers develop ultrathin, ultralight 'nanocardboard'

When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure

Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

European Space Talks: Weltraumschrott – eine Gefahr für die Gesellschaft?

23.10.2018 | Event News

 
Latest News

UNH scientists help provide first-ever views of elusive energy explosion

16.11.2018 | Physics and Astronomy

How the gut ‘talks’ to brown fat

16.11.2018 | Life Sciences

Massive impact crater from a kilometer-wide iron meteorite discovered in Greenland

15.11.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>