Fungal Meningitis Patients: A Long Road to Recovery
An Outbreak Without Precedent continued...
What's worse, though the pace of new infections has slowed, doctors continue to find more.
Based on previous experience, doctors had expected that they could see new cases of fungal infections cropping up as long as four months after patients received their tainted meds. Since the contaminated steroid shots were recalled on Sept. 26, that would mean that people who had been exposed could be in the clear by late January. But even that timeline is shifting.
"We've got incubations now of documented cases beyond 120 days. I just heard of one the other day that was 125. The question now is how long can these sit before they manifest?" Chiller says.
"I don't think we're done yet. I don't think we're at the end, but I certainly hope we're close," he says.
A Second Wave of Infections
Since her diagnosis, Johnnie has been hospitalized three times. Twice she was admitted for more than a month.
In November, doctors found a new pocket of infection deep in her back that was pressing on her spine.
She wasn't the only one.
"About a month ago, it became evident that in addition to meningitis, a second problem was developing," says Schaffner. "That was these abscesses in the tissue where the epidural injections had taken place."
The abscesses were happening to patients like Johnnie who were already exhausted by a fight with meningitis. But they were also cropping up in otherwise healthy people who thought they were in the clear.
"They're so deep and there's so little active inflammation that the skin is smooth. It's not red. It's not puffy. There's no drainage on the surface of the body. So they have to be detected internally," usually with an MRI, Schaffner says.
Diagnosis of the abscesses can be difficult.
"They can present with symptoms, most commonly pain. However, these people had pain there to begin with, and they frequently cannot distinguish pain and pressure from the abscess from the sort of nerve pain that they had before," he says.
Johnnie had surgery to remove her abscess. "That's when she really began to get better," says Fred.
She came home in early December, expecting to stay. But last week she was rushed back to her local hospital. The powerful antifungal drugs that she and other patients will need to take for up to a year had caused her potassium to drop to dangerously low levels.
After days on an IV to get her stabilized, she was allowed to come home, just in time for Christmas. Fred expects they won't do much this year. "But we'll have our family together. I got my wife here. That's about all I need."