Detailed research published in The New England Journal of Medicine describes a deadly fungal meningitis outbreak related to medical facilities in Matamoros, Mexico, that killed 12 individuals.
Meningitis is an inflammation of the brain and spinal cord's protective membranes, accompanied by fever, headache, stiffness of the neck, nausea, vomiting, disorientation, and light sensitivity. Viruses, bacteria, trauma, or fungus can trigger it.
Following epidural anesthesia for breast implants, butt lifts, or liposuction, 24 patients, mostly from Texas, developed fungal meningitis. Patients exhibited symptoms within three days to six weeks post-surgery, per a June 2023 report from AP News.
Aggressive Fungus Found
The recent research on the meningitis outbreak case published on February 8, found that Fusarium solani was in the epidural anesthetic, which contaminated the patients' cerebrospinal fluid, which nourishes and protects the spinal cord and brain and eliminates waste.
(Photo : ABRAHAM PINEDA/AFP via Getty Images)
View of signs at the entrance of one of the medical clinics suspended by Mexican health authorities in Matamoros, Tamaulipas, Mexico on May 19, 2023.
A team of researchers from the University of Texas and the Centers for Disease Control and Prevention (CDC) carefully reviewed 13 patients' imaging, pathology reports, and electronic health data, NBC News reported. Their scrutiny revealed a significant and alarming development-the fungus aggressively targeted the brainstem, particularly its vessel-rich areas.
Dr. Luis Ostrosky, Chief of Infectious Diseases and Epidemiology with UTHealth Houston and Memorial Hermann Health System, elucidated the observed phenomenon, stating, "What we ended up seeing is, literally, this fungus eating through blood vessels and causing clotting as well." This aggressive attack led to severe consequences for patients, including strokes, brain hemorrhages, and increased pressure within the brain as inflammation obstructed spinal fluid flow.
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The findings are crucial for clinicians, providing unexpected insights into the specific impact of the fungus on the brainstem. Dr. Celeste Philip, Senior Public Health Adviser of Health and Medical Affairs at the American Public Health Association, emphasized that this discovery could be instrumental in alerting clinicians to future cases, potentially leading to improved and quicker diagnosis and treatment.
Dr. Katrina Byrd, a CDC infectious disease expert and epidemic intelligence officer, says early response reduces illness severity. Early identification and treatment lessen infection duration and severity.
What Happnened?
In the Matamoros outbreak, a significant number of patients were not promptly evaluated or treated, with delays extending over a month after the onset of meningitis symptoms. Some patients were initially misdiagnosed with post-epidural headaches, while others, lacking health insurance, chose to ignore their symptoms.
According to Medical Xpress, out of the 13 patients, nine succumbed to vessel injuries. Among the four survivors, three continue to undergo Fosmanogepix monotherapy-an experimental treatment designed for invasive mold infections-while one has ceased taking the antifungal medication. Following a subarachnoid hemorrhage, a patient who is still receiving therapy developed abulia, which is characterized by decreased motivation. However, the remaining three patients did not experience any cognitive, sensory, or motor deficits resulting from the infection.
Dallas Smith, an epidemiologist with the CDC's National Center for Zoonotic and Emerging Infectious Diseases, led the agency's efforts in addressing the outbreak, overcoming challenges in growing the Fusarium fungus in lab conditions from spinal fluid samples with successful cultivation obtained from the brain of a deceased patient.
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