A recent outbreak of fungal meningitis cases in the U.S. has been tied to a single center in Matamoros, Mexico, where affected individuals received epidural anesthesia, according to a July report published by the CDC.
Here are 10 things to know about the outbreak:
1. In the report, authors investigated a fungal meningitis outbreak that began in May 2023 when two women in Texas developed meningitis after undergoing cosmetic procedures under epidural anesthesia in Mexico.
2. The researchers identified a total of 233 potential patients who underwent epidurals for mainly cosmetic surgery at one of two now-closed clinics in Mexico between Jan. 1 and May 13, 2023.
3. A total of 170 individuals were contacted; 104 reported receiving epidural anesthesia and were deemed at risk for meningitis. Of these, at least 30 individuals received a diagnostic lumbar puncture, and 24 were diagnosed with fungal meningitis.
4. Half of the meningitis patients died, and all identified cases involved epidural anesthesia delivered by the same anesthesiologist in Mexico.
5. The median age of the 24 confirmed and possible cases was 31 years. All cases but one were women.
6. The most common symptoms on presentation were headache, nausea and a stiff neck. The average time from symptom onset to antifungal treatment was 39 days among patients who died and 52 days among those who survived. Of the seven patients treated with fosmanogepix in the wake of updated recommendations, six survived.
7. In patient questionnaire responses, the high cost of medical procedures in the U.S. was the most cited reason for seeking care abroad.
8. Previously, the CDC provided technical support for Mexican investigators responding to a similar outbreak in Durango, Mexico, that did not involve U.S. citizens, Medscape Medical News reported Aug. 20. Durango and Matamoros are geographically far apart, leaving investigators doubtful that the outbreaks were connected. Whole genome sequencing showed isolates from patients in the two locations were genetically distant, but isolates from patients treated at the Matamoros clinic were closely related.
9. Researchers told Medscape that the high mortality rate of more than 50% among the Matamoros patients was “shocking,” as most of the patients were young, healthy women, highlighting the dangers of fungal infections.
10. Researchers also said that because fungal meningitis cases are less common than bacterial ones, clinicians may not immediately suspect a fungal etiology, which may delay necessary testing to confirm diagnosis.
