The FDA (http://www.fda.gov/Drugs/DrugSafety/ucm322734) reported a patients with possible meningitis potentially associates with epidural injection of an additional NECC product. Triamcinolone acetonide, has been identified through active surveillance and reported to the FDA. Triamcinolone acetonide is a type of steroid injectable product made by NECC. The cases of meningitis identified to date have been associated with methylprednisolone acetate, another similar steroid injectable product.

In addition, two transplant patients with an Aspergillus fumigatus infection who were administered NECC cardioplegic solution during surgery have been reported. Investigation of the patients is ongoing as there may be other explanations for the Aspergillus infection. Cardioplegic solution is used to induce cardiac muscle paralysis during open heart surgery to prevent injury to the heart.

Meningitis (http://www.cdc.gov/meningitis/fungal.html) affects the membranous lining of the brain and spinal cord. Early symptoms of fungal meningitis, such as headache, fever, dizziness, nausea, sensitivity to light, stiff neck, weakness or numbness, slurred speech and pain, redness or swelling at the injection site can take more than a month to appear.

The longest duration from the time of injection to the onset of symptoms in the current outbreak is 42 days, according to the CDC’s Dr. Benjamin Park (http://www.cdc.gov/media/releases2012/docs/dpk-meningitis-park-bio.pdf) .