{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T07:23:56Z","timestamp":1773991436586,"version":"3.50.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>\n              The current fungal meningitis outbreak caused by contaminated epidural anesthesia with\n              <jats:italic toggle=\"yes\">Fusarium solani<\/jats:italic>\n              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.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Three female patients (mean age, 35 years) with CVC due to iatrogenic fungal meningitis were included. Positive Fungitell \u03b2-D-glucan assay in cerebrospinal fluid was documented in all cases, and\n              <jats:italic toggle=\"yes\">F<\/jats:italic>\n              .\n              <jats:italic toggle=\"yes\">solani<\/jats:italic>\n              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\u2019 death.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>\n              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\n              <jats:italic toggle=\"yes\">F<\/jats:italic>\n              .\n              <jats:italic toggle=\"yes\">solani<\/jats:italic>\n              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.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.044768","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T13:00:37Z","timestamp":1701262837000},"page":"177-181","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cerebrovascular Complications Associated With Iatrogenic Fungal Meningitis Following Surgical Procedures in Mexico"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-5646","authenticated-orcid":true,"given":"Andrea","family":"Becerril-Gaitan","sequence":"first","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivani","family":"Bindal","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-8117","authenticated-orcid":true,"given":"Samantha L.","family":"Parker","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"Mullarkey","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussein A.","family":"Zeineddine","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justine M.","family":"Chen","sequence":"additional","affiliation":[{"name":"Neurology Department (J.M.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimahn A.","family":"Choi","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8438-132X","authenticated-orcid":true,"given":"Peng R.","family":"Chen","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-5079","authenticated-orcid":true,"given":"Spiros","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1806-2755","authenticated-orcid":true,"given":"Arthur","family":"Day","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3654-0485","authenticated-orcid":true,"given":"Luis F.","family":"Torres","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2262-0855","authenticated-orcid":true,"given":"Ritvij","family":"Bowry","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-9273","authenticated-orcid":true,"given":"Ching-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"Centers for Disease Control and Prevention (CDC). Fungal infections following surgical procedures in Mexico. Accessed August 2023. https:\/\/www.cdc.gov\/hai\/outbreaks\/meningitis-epidural-anesthesia.html"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-1-201212040-00557"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26618"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-021-02778-9"},{"key":"e_1_3_3_7_2","unstructured":"Centers for Disease Control and Prevention (CDC). Outbreak of suspected fungal meningitis in U.S. patients who underwent surgical procedures under epidural anesthesia in Matamoros Mexico. Accessed August 2023. https:\/\/emergency.cdc.gov\/han\/2023\/han00492.asp"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12915-022-01436-7"},{"key":"e_1_3_3_9_2","unstructured":"Pulice C. Death toll from mysterious meningitis outbreak in Mexico at 35. Accessed August 2023. https:\/\/www.reuters.com\/business\/healthcare-pharmaceuticals\/death-toll-mysterious-meningitis-outbreak-mexico-35-2023-02-06\/"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.3586"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212972"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.123.044768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T13:15:33Z","timestamp":1749042933000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.123.044768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1161\/STROKEAHA.123.044768"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.123.044768","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-09","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}