Cerebrovascular Complications Associated With Iatrogenic Fungal Meningitis Following Surgical Procedures in Mexico.

BACKGROUND: The current fungal meningitis outbreak caused by contaminated epidural anesthesia with Fusarium solani among patients who underwent surgical procedures in Matamoros, Mexico remains a cause of concern. Its association with an increased susceptibility for cerebrovascular complications (CVC) has not been reported. This single-center study describes 3 patients with a unique pattern of CVC attributed to fungal meningitis. METHODS: A retrospective case series of patients diagnosed with fungal meningitis following surgical procedures under contaminated epidural anesthesia who developed a unique pattern of CVC during their hospitalization. RESULTS: Three female patients (mean age, 35 years) with CVC due to iatrogenic fungal meningitis were included. Positive Fungitell ß-D-glucan assay in cerebrospinal fluid was documented in all cases, and F. solani was confirmed by polymerase chain reaction in case 3. All cases were complicated by severe vertebrobasilar circulation vasculopathy and arterial dissections with resultant subarachnoid hemorrhage and intraventricular hemorrhage, ultimately leading to patients' death. CONCLUSIONS: The death toll from the ongoing fungal meningitis outbreak keeps rising, underscoring the need for early recognition and aggressive treatment. We highlight the risk for vertebrobasilar circulation CVC among these patients. The angioinvasive nature of F. solani is yet to be clarified; however, a clear pattern has been observed. Public health awareness should be raised and a strong response should be pursued.

Geographical analysis of seroprevalence of Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis, in clinics and dog shelters in different Mexican states.

This study aimed to determine the seroprevalence and geographical distribution of Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis in dogs in Mexico, including owned dogs from veterinary clinics with regular medical care and shelter dogs. The Mexican territory was divided into eight geographical regions; 22 out of 32 states were included; 110 veterinary clinics and 53 dog shelters participated. SNAP® 4Dx Plus® (IDEXX® Laboratories) was used to detect antibodies against Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis antigens. A total of 3522 apparently healthy dogs were tested, 1648 from clinics and 1874 from shelters. The highest seroprevalence of infection/exposure was found for Ehrlichia spp. (30.9%), followed by Anaplasma spp. (14.6%), D. immitis (5.3%) and B. burgdorferi (0.1%). Significantly more positive dogs were older than 3 years. Regarding differences between facility types, there were only differences for D. immitis which was more prevalent in clinics than in shelters (OR â€‹= â€‹1.97; 95% CI: 1.45-2.69; P â€‹< â€‹0.0001). Co-infections were detected in 38.4% of the positive samples. Dogs from Mexican states located on the Atlantic and the Pacific coast were significantly more at risk for Ehrlichia spp. and Anaplasma spp. infections than dogs from interior states. Dogs in Atlantic coastal states were more at risk for Dirofilaria immitis infection.