Update on Outbreak of Fungal Meningitis Among US Residents Who Received Epidural Anesthesia at Two Clinics in Matamoros, Mexico

Authors

• Dallas J Smith
• Jeremy A W Gold
• Tom Chiller
• Nirma D Bustamante
• Maria Julia Marinissen
• Gabriel Garcia Rodriquez
• Vladimir Brian Gonzalez Cortes
• Celida Duque Molina
• Samantha Williams
• Axel A Vazquez Deida
• Katrina Byrd
• Peter G Pappas
• Thomas F Patterson
• Nathan P Wiederhold
• George R Thompson
• Luis Ostrosky-Zeichner

Language

English

Publication Date

6-14-2024

Journal

Clinical Infectious Diseases

DOI

10.1093/cid/ciad570

PMID

37739479

PMCID

PMC10957502

PubMedCentral® Posted Date

6-14-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Public health officials are responding to an outbreak of fungal meningitis among patients who received procedures under epidural anesthesia at 2 clinics (River Side Surgical Center and Clinica K-3) in Matamoros, Mexico, during 1 January to 13 May 2023. This report describes outbreak epidemiology and outlines interim diagnostic and treatment recommendations.

Methods: Interim recommendations for diagnosis and management were developed by the Mycoses Study Group Research Education and Consortium (MSGERC) based on the clinical experience of clinicians caring for patients during the current outbreak or during previous outbreaks of healthcare-associated fungal meningitis in Durango, Mexico, and the United States.

Results: As of 7 July 2023, the situation has evolved into a multistate and multinational fungal meningitis outbreak. A total of 185 residents in 22 US states and jurisdictions have been identified who might be at risk of fungal meningitis because they received epidural anesthesia at the clinics of interest in 2023. Among these patients, 11 suspected, 10 probable, and 10 confirmed US cases have been diagnosed, with severe vascular complications and 8 deaths occurring. Fusarium solani species complex has been identified as the causative agent, with antifungal susceptibility testing of a single isolate demonstrating poor in vitro activity for most available antifungals. Currently, triple therapy with intravenous voriconazole, liposomal amphotericin B, and fosmanogepix is recommended.

Conclusions: Efforts to understand the source of this outbreak and optimal treatment approaches are ongoing, but infectious diseases physicians should be aware of available treatment recommendations. New information will be available on the Centers for Disease Control and Prevention's (CDC's) website.

Keywords

Humans, Disease Outbreaks, United States, Mexico, Meningitis, Fungal, Female, Male, Adult, Anesthesia, Epidural, Antifungal Agents, Middle Aged, Young Adult, Aged, Adolescent

Published Open-Access

yes

Recommended Citation

Smith, Dallas J; Gold, Jeremy A W; Chiller, Tom; et al., "Update on Outbreak of Fungal Meningitis Among US Residents Who Received Epidural Anesthesia at Two Clinics in Matamoros, Mexico" (2024). Faculty, Staff and Student Publications. 3689.
https://digitalcommons.library.tmc.edu/uthmed_docs/3689