Based on our experience with our hip implant clients, we know that many of them receive  steroid injections to help them cope with hip pain.  Any patient who has received steroid injections to treat pain in their hips or other joints should be aware of the scope of the recent meningitis outbreak from steroid injections prepared by the New England Compounding Center (NECC) of Framingham, Massachusetts.

Late last month, epidural steroid injections prepared by NECC were implicated in hundreds of cases of fungal meningitis, as well as some incidents of peripheral joint infections.    NECC has since announced an epidural steroid recall, along with a recall of all of its products.  Most patients who received these steroid injections were being treated for back pain.  However, some also received injections to treat joint pain.

If you received steroid injections for your hip pain after May 21, 2012, here’s what you need to know:

What is Fungal Meningitis? Fungal meningitis occurs when the protective membranes covering the brain and spinal cord are infected with a fungus.  According to the Centers for Disease Control (CDC), fungal meningitis is not contagious, and can’t be transmitted person-to-person.

The Scope of the Fungal Meningitis OutbreakAccording to the CDC’s latest update, 304 cases of fungal meningitis, including 23 deaths, associated with recalled NECC steroids have been reported in 16 states.   Four peripheral joint infections have also been blamed on the steroids.

NECC Epidural Steroid Recall:  In September 2012, NECC issued an epidural steroid recall for 17,000 vials of preservative-free methylprednilosone injections. The recalled epidural steroids were distributed to 76 facilities in 23 states. Some 14,000 people are known to have been injected with the recalled steroid vials, according to the CDC.

Other Drugs Recalled by NECC:  On October 6, NECC recalled all of its products and voluntarily surrendered its license to operate.  A complete list of products subjected to the NECC recall is available at the U.S. Food & Drug Administration’s website:  According to the FDA, NECC medications were distributed to more than 1,200 clinics and hospitals.  A complete list of the healthcare facilities that received these products is also available at the FDA’s website.  Facilities that received any of these products have been asked to follow-up with patients.

 Infections Possibly Tied to Other NECC Drugs:   The FDA recently reported that at least one case of fungal meningitis has been found in a patient who was administered triamcinolone acetonide, another steroid injection prepared by NECC. Two additional infections have been reported in transplant patients who received NECC cardioplegic solution during surgery.  The FDA is working to confirm if those drugs are the cause of the infections, but has asked doctors to avoid using any NECC products.

Symptoms of Fungal Meningitis:   According to the CDC,  symptoms of fungal meningitis may include:

  • New or worsening headache
  • Fever Sensitivity to light
  • Stiff neck
  • New weakness or numbness in any part of your body
  • Slurred speech Increased pain, redness or swelling at your injection site

Symptoms of Peripheral Joint Infections:  According to the CDC, symptoms of peripheral joint infections associated with NECC steroids may include:

  • Fever
  • Increased pain
  • Redness, warmth, or swelling in the joint that received the injection or at the injection site

What Should Patients Do? The CDC is advising patients who are worried they may have been exposed to contaminated NECC steroids to contact their healthcare provider to determine if they were treated with an NECC product.  If so, patients should remain vigilant for signs of fungal meningitis and peripheral joint infections and contact their doctor at once if they develop any symptoms.  Patients who have received steroid injections at facilities not on the FDA’s list should still contact their doctor if they develop any symptoms indicative of fungal meningitis or peripheral joint infections, the CDC said.