Probable Case:
A person who received an injection with methylprednisolone acetate produced by the New England Compounding Center who developed any of the following:

  1. Meningitis of unknown etiology following epidural injection after May 21, 2012.
  2. Stroke following epidural injection after May 21, 2012, who has not received a diagnostic lumbar puncture.
  3. Spinal osteomyelitis or epidural abscess of unknown etiology at the site of injection following epidural or sacroiliac injection after May 21, 2012.
  4. Osteomyelitis or worsening inflammatory arthritis of a peripheral joint (e.g., knee) of unknown etiology diagnosed following joint injection after May 21, 2012.

Confirmed Case:
A probable case with evidence of a fungal pathogen (by culture, histopathology, molecular, or antigen-based assay) associated with the clinical syndrome.

Patients under investigation:
A person who developed an infection of a normally sterile site (e.g., blood, CSF, pleural fluid, peritoneal fluid, pericardial fluid, surgical aspirate, bone, joint fluid, or internal body site (e.g., lymph node, brain)) following use of a product labeled as sterile prepared by the New England Compounding Center.