Americans have died from a fungal infection caught during medical procedures in Mexico, a study reports.
Over a dozen patients who traveled to Mexican clinics for treatment came down with the mold infection, Fusarium solani meningitis, after they received epidural anesthesia before their surgery, a report from UTHealth Houston found. Mexico is a popular destination for medical tourism, which is where people go to another country for medical procedures, usually because of cheaper costs.
The report on the incident, published in The New England Journal of Medicine, was led by first author Nora Strong and senior author Luis Ostrosky-Zeichner.
These infections occur after the spinal injections for the anesthesia introduce this strain of mold into the system, causing the severe infection. This outbreak spread across 13 patients in two clinics in the Mexican city of Matamoros between January 1, 2023, and May 13, 2023. Fungal meningitis develops after fungal infections spread to the brain or spinal cord.
Those with weaker immune systems are at an increased risk if they develop the infection. Treatment options usually depend on catching the illness early. It can turn into a life-threatening condition very quickly.
"The outbreak of this severe mold infection affected primarily young, otherwise healthy people as a result of medical tourism," Strong said in a summary of the report. "Patients from Mexico and the U.S. experienced severe, and ultimately mortal, neurologic and vascular injuries as a result of the infection."
All of these patients had otherwise very healthy immune systems and were in good health.
"All 13 patients featured involvement of the brainstem with injury to the basilar and vertebral arteries, which were typically insidious at presentation but progressed," Strong said. "Over time, multiple patients experienced the narrowing of important blood vessels in their brains, leading to stroke or severe hemorrhages that eventually led to death in many of the patients."
Nine out of all 13 patients died from this deadly infection. Of those who survived, three are still receiving treatment for invasive mold infections and one is off an antifungal medication.
One patient, who is still receiving therapy, is still suffering from abulia due to a hemorrhage. This is a condition that affects a person's motivation to move, speak or think. At first, clinicians tried antifungal therapies. While these helped improve symptoms in some patients, their condition worsened because of "rapid fungal growth."
"Eventually, we learned through advanced molecular and microbiological techniques that the fungus was resistant to all antifungal agents, except the experimental drug Fosmanogepix," Ostrosky-Zeichner said in the report's summary.
"Using that, along with state-of-the-art neurosurgical and endovascular techniques, changed the course of the outbreak. Undoubtedly, multidisciplinary work across institutions and agencies saved the remaining patients," Ostrosky-Zeichner said.
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