Thursday, October 18, 2012

MENINGITIS AND SEPTIC ARTHRITIS

FROM: U.S. CENTERS FOR DISEASE CONTROL,

Case Definitions for Meningitis and Septic Arthritis

Probable Case
A person who received a methylprednisolone acetate (MPA) injection, with MPA that was definitely or likely produced by the New England Compounding Center (NECC), and subsequently developed any of the following
Meningitis1 of unknown etiology following epidural or para-spinal injection 2 after May 21, 2012;
Posterior circulation stroke without a cardioembolic source and without documentation of a normal cerebrospinal fluid (CSF) profile, following epidural or para-spinal injection2 after May 21, 2012;3
Osteomyelitis or abscess of unknown etiology in the spinal or para-spinal structures at the site of injection following epidural or para-spinal injection2 after May 21, 2012; or
Osteomyelitis or worsening inflammatory arthritis of a peripheral joint (e.g., knee, shoulder, or ankle) of unknown etiology diagnosed following joint injection after May 21, 2012.

1 Clinically diagnosed meningitis with one or more of the following symptoms: headache, fever, stiff neck, or photophobia, in addition to a CSF profile showing pleocytosis (>5 white blood cells, adjusting for presence of red blood cells by subtracting 1 white blood cell for every 500 red blood cells present) regardless of glucose or protein levels.

2 Para-spinal injections include, but are not limited to, spinal facet joint injection, sacroiliac joint injection, spinal or para-spinal nerve root/ganglion block, or blood patch.

3 Patients in this category who do not have any documented CSF results should have a lumbar puncture performed if possible.

Confirmed Case
A probable case with evidence (by culture, histopathology, or molecular assay) of a fungal pathogen associated with the clinical syndrome.

Post-ProceduralIinfection in Patients Exposed to Non-MPA NECC Products
A patient who developed an infection in a normally sterile site4 following use of one or more products labeled as sterile and prepared by NECC, excluding MPA.

4 Normally sterile sites include blood, CSF, pleural fluid, peritoneal fluid, pericardial fluid, surgical aspirate, bone, joint fluid, or internal body site (e.g., lymph node or brain).


 



 

 

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