(HealthDay News) – About a fifth of patients who have received a spinal injection of fungus-contaminated methylprednisolone but have not sought medical care are likely to be infected, according to a study published in the June 19 issue of the Journal of the American Medical Association.

Contaminated methylprednisolone from the New England Compounding Center led to an outbreak of spinal or paraspinal fungal infections at the injection site in the fall of 2012. Noting that some infections stemming from this outbreak may have remained undiagnosed, Anurag N. Malani, MD, from St. Joseph Mercy Hospital in Ann Arbor, Mich., and colleagues used contrast-enhanced magnetic resonance imaging (MRI) to screen 172 patients who had been injected with the contaminated methylprednisolone but had not presented for medical care related to adverse effects after the injection.

The researchers found that 36 patients (21%) had an abnormal MRI, and nearly all of these patients met the U.S. Centers for Disease Control and Prevention criteria for probable or confirmed fungal spinal or paraspinal infection. Of the 24 patients who required surgery, 71% had laboratory evidence of fungal infection, including five patients who denied having symptoms. Of the 115 patients asked about relevant symptoms, 30% had at least one.

“Screening MRI led to identification of patients who had minimal or no symptoms of spinal or paraspinal infection and allowed early initiation of medical and surgical treatment,” Malani and colleagues conclude.

Several authors disclosed financial relationships with biotechnology and pharmaceutical companies.

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