Loading...
During the last few months of 2012, an outbreak of fungal meningitis was traced to contaminated vials of methylprednisolone that were used for epidural steroid injections. Clinical presentations have included insidious meningitis, basilar stroke, and vertebral osteomyelitis or epidural abscesses (JW Infect Dis Oct 17 2012). As of early December 2012, nearly 600 cases from 19 states had been reported, with 37 deaths. This outbreak has focused a great deal of attention on the practice of epidural steroid injections for patients with lumbosacral or cervical spine disease and radicular symptoms. However, evidence to support these procedures has been mixed. During 2012, we covered two reports in which the efficacy of epidural steroid injections …