• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Infectious Disease

Exserohilum rostratum acquired by contaminated injections linked with broad disease

bys25qthea
October 23, 2013
in Infectious Disease, Neurology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD 

1. Based on experience from the largest health care-associated outbreak, Exserohilum rostratum commonly results in meningitis, epidural abscess and arachnoiditis when introduced through epidural and paraspinal injections. 

2. Death from this outbreak was strongly associated with patients that experienced strokes. 

Evidence Rating Level: 4 (Below Average)          

Study Rundown: The largest health care-associated outbreak of Exserohilum rostratum occurred in September 2012, after patients received epidural, paraspinal and joint injections from a contaminated lot of methylprednisolone acetate. This study documented the clinical conditions that arose from this outbreak, which included fungal meningitis, stroke and epidural abscess. 

E. rostratum – typically a rare human pathogen – was the most frequently isolated organism in these patients. Infection likely resulted from a combination of direct spread from the site of injection coupled with suppression of normal host immunity by the steroid.

RELATED REPORTS

2 Minute Medicine Rewind June 16, 2025

Use of psychiatric medications may be associated with a higher risk of amyotrophic lateral sclerosis

Impaired lipoprotein cholesterol ratio is associated with cognitive impairment in patients with stroke

Among 328 patients included in this study, the three most common disease types observed were: meningitis, epidural abscess, and arachnoiditis. Stroke was the most common cause of death in this outbreak and for those that experienced strokes, the vertebrobasilar vessel was most commonly involved.

This study described the various clinical manifestations of fungal infections that can be introduced from epidural and paraspinal injections. While it is a comprehensive review of the recent outbreak, limitations include the size of the study, the geographic restrictions of data from only six states as well as the fact that E.rostratum was only isolated in 36% of patients in this study. Therefore, the clinical presentation trends cannot be completely attributed to infection with this species.

Click to read the study, published today in NEJM

In-Depth [case series]: This study included 328 patients who received epidural, paraspinal, or joint injections from contaminated lots of methylprenisolone acetate after May 21, 2012. Disease types within these patients included both central nervous system (CNS) disease (81%) and non-CNS disease (19%). The most common disease types were meningitis (N=250), epidural abscess (N=90) and arachnoiditis (N=63). Samples were obtained from 268 of 328 patients for testing, of which 96 (36%) had laboratory evidence of E. rostratum.

For the 30 patients diagnosed with stroke and localizable symptoms, arterial involvement included vertebrobasilar, basal ganglia and cerebral cortex (77%, 53%, 3%, respectively). The time interval from injection to diagnosis was shortest for stroke and longest for epidural abscess (median of 21 v. 39 days, p<0.001). Among the 26 deaths that occurred, 85% of these patients experienced a stroke.

By Jonathan Liu, MD and Adrienne Cheung

More from this author: Combo antifungal therapy most effective treatment for cryptococcal meningitis, Rhinovirus, genes may interact to increase risk of childhood asthma, Functional MRI map for physical pain identified Glutamine and antioxidant supplementation provide no benefit for critically-ill patients New Hepatitis C virus (HCV) treatment effective   

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. 

Tags: Exserohilum rostratumneurology
Previous Post

Influenza vaccine associated with lower risk of major cardiovascular events

Next Post

A new genetic test for susceptibility to dapsone hypersensitivity syndrome

RelatedReports

Survival greater in cervical cancer patients undergoing abdominal hysterectomy compared to minimally invasive techniques: the LACC trial
Weekly Rewinds

2 Minute Medicine Rewind June 16, 2025

June 16, 2025
Quick Take: The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomized trial
Chronic Disease

Use of psychiatric medications may be associated with a higher risk of amyotrophic lateral sclerosis

June 12, 2025
Quick Take: Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial
Chronic Disease

Impaired lipoprotein cholesterol ratio is associated with cognitive impairment in patients with stroke

June 4, 2025
Sleep duration, sleepiness, chronotype have variable associations with teen self-regulation
Chronic Disease

Oveporexton improves symptoms in patients with narcolepsy type 1

June 3, 2025
Next Post
A new genetic test for susceptibility to dapsone hypersensitivity syndrome

A new genetic test for susceptibility to dapsone hypersensitivity syndrome

Wound surgical device found ineffective at infection control: ROSSINI Trial

Early results favor laparoscopic sleeve gastrectomy over gastric bypass

Further evidence of link between antithyroid drugs in pregnancy and birth defects

Further evidence of link between antithyroid drugs in pregnancy and birth defects

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Fecal microbiota transplantation may be more effective than vancomycin in treating primary C. difficile infection
  • Frailty scores alone may be poor predictors of intensive care admission or hospital stay duration
  • Anal cancer screening cost-effective for men who have sex with men with human immunodeficiency virus aged above 35 years
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.